F13.988 maps to CMS-HCC V28 137. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC coding software

ICD-10-CM Code View

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Code lookupF13.988

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Mental and behavioral disorders due to psychoactive substance use (F10-F19)

F13.988

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Sedative, hypnotic or anxiolytic use, unspecified with other sedative, hypnotic or anxiolytic-induced disorder

This code describes a situation where someone is using sedative, hypnotic, or anxiolytic medications (drugs that calm or help with sleep) in an unspecified way and has developed another related health problem caused by these drugs. The specific type of problem is not further detailed in this code.

Buddy Insight

This code captures other specified substance-induced disorders from unspecified sedative use that do not fit standard categories.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

Mapped

HCC 137

Drug Use Disorder, Moderate/S...

Coefficient HCC 137: 0.424 (Community Non-Dual Aged (CNA))

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

Mapped

HCC 082

HHS-HCC 082 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 55

Substance Use Disorder/Modera...

Code-level coefficient reference

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

F13.9Sedative, hypnotic or anxiolytic-related use, unspecified F13.98Sedative, hypnotic or anxiolytic use, unspecified with other sedative, hypnotic or anxiolytic-induced disorders F13.988Sedative, hypnotic or anxiolytic use, unspecified with other sedative, hypnotic or anxiolytic-induced disorder

Inclusion Terms

Official

Sedative, hypnotic, or anxiolytic-induced mild neurocognitive disorder

Excludes 2

Official

symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99)Inherited from F01-F99

Related Codes

Official

F13.980Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced anxiety disorder F13.981Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced sexual dysfunction F13.982Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced sleep disorder

Includes

Official

disorders of psychological developmentInherited from F01-F99

Excludes 1

Official

sedative, hypnotic or anxiolytic-related abuse (F13.1-)Inherited from F13.9
sedative, hypnotic or anxiolytic-related dependence (F13.2-)Inherited from F13.9

Code First

Official

No Code First sequencing instructions are included in this display for F13.988. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for F13.988. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for F13.988. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Documentation of sedative, hypnotic, or anxiolytic use

Clear description of the specific induced disorder

Provider documentation establishing causal link to the substance

Clinical rationale for why more specific codes do not apply

MEAT Support

HCC Buddy guidance

Documentation of sedative, hypnotic, or anxiolytic use

Clear description of the specific induced disorder

Provider documentation establishing causal link to the substance

Clinical rationale for why more specific codes do not apply

Audit Caution

HCC Buddy guidance

Using this code when a more specific induced disorder code exists

Confusing 'other specified' with 'unspecified' — the disorder IS known, just atypical

Not documenting what the 'other' disorder actually is

Using this code when abuse or dependence classification is available

Common Mistakes

HCC Buddy guidance

F13.99 — Unspecified use with unspecified induced disorder; use when disorder type is unknown

F13.980 — Induced anxiety disorder; use if anxiety is the specific condition

F13.982 — Induced sleep disorder; use if sleep problems are the specific condition

F13.188 — Sedative ABUSE with other induced disorder; when abuse is confirmed

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is F13.988 an HCC code?

Yes. F13.988 (Sedative, hypnotic or anxiolytic use, unspecified with other sedative, hypnotic or anxiolytic-induced disorder) maps to HCC 137, Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.424. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: F13.988 is billable and maps to V28 HCC 137, Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: F13.988
Description: Sedative, hypnotic or anxiolytic use, unspecified with other sedative, hypnotic or anxiolytic-induced disorder
HCC (V28): HCC 137 — Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
RAF reference coefficient: 0.424
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 137, Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications

0.424

ESRDHCC 55, Substance Use Disorder/Moderate/Severe/Substance Use with Complications

Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work F13.988 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for F13.988

For F13.988, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
EEvaluate: test results, medication response, or physical findings reviewed by the provider
AAssess: explicit mention in the assessment or plan with acknowledgment of status
TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Coder workflow notes

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What This Code Means

F13.988 is the ICD-10-CM diagnosis code for sedative, hypnotic or anxiolytic use, unspecified with other sedative, hypnotic or anxiolytic-induced disorder. This code describes a situation where someone is using sedative, hypnotic, or anxiolytic medications (drugs that calm or help with sleep) in an unspecified way and has developed another related health problem caused by these drugs. The specific type of problem is not further detailed in this code. F13.988 sits in the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99), within the section covering mental and behavioral disorders due to psychoactive substance use (f10-f19).

Under the CMS-HCC V28 risk adjustment model, F13.988 maps to Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications (HCC 137) with a source-labeled community, non-dual, aged reference coefficient of 0.424. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

Use this code only when the documentation indicates sedative/hypnotic/anxiolytic use with an induced disorder that doesn't fit more specific F13 subcategories (such as F13.980 for anxiety or F13.982 for sleep disorder). For F13.988, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for F13.988 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Use this code only when the documentation indicates sedative/hypnotic/anxiolytic use with an induced disorder that doesn't fit more specific F13 subcategories (such as F13.980 for anxiety or F13.982 for sleep disorder)
•Verify the documentation clearly states the disorder is induced by the sedative/hypnotic/anxiolytic use rather than being a pre-existing condition, and confirm the pattern of use is unspecified (not in remission, early remission, or sustained remission)

Clinical Significance

This code captures other specified substance-induced disorders from unspecified sedative use that do not fit standard categories. It serves as a catch-all for unusual complications that are known but do not match anxiety, sexual, sleep, mood, or psychotic disorder classifications. Examples include substance-induced obsessive-compulsive symptoms or movement disorders.

Documentation Requirements

✓Documentation of sedative, hypnotic, or anxiolytic use
✓Clear description of the specific induced disorder
✓Provider documentation establishing causal link to the substance
✓Clinical rationale for why more specific codes do not apply
✓Assessment supporting the diagnosis
✓Treatment plan for both substance use and the induced disorder

Commonly Confused Codes

•F13.99: Unspecified use with unspecified induced disorder; use when disorder type is unknown
•F13.980: Induced anxiety disorder; use if anxiety is the specific condition
•F13.982: Induced sleep disorder; use if sleep problems are the specific condition
•F13.188: Sedative ABUSE with other induced disorder; when abuse is confirmed
•F13.288: Sedative DEPENDENCE with other induced disorder; when dependence is confirmed