F14.10
BillableCocaine abuse, uncomplicated
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F14.10 an HCC code?
Yes. F14.10 maps to Drug Use Disorder/Substance Use Disorder, Mild under the CMS-HCC V28 risk adjustment model (and Drug/Alcohol Abuse, Without Dependence under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
MEAT Criteria for F14.10
For F14.10 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically — it has to be re-documented and supported each calendar year.
- 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
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed F14.10 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F14.10 is the ICD-10-CM diagnosis code for cocaine abuse, uncomplicated. A person abuses cocaine but does not have severe cocaine use disorder and has no current complications from the use. F14.10 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, F14.10 maps to Drug Use Disorder/Substance Use Disorder, Mild (HCC 138) with a community, non-dual, aged base RAF weight of 0.476. Under the older CMS-HCC V24 model, F14.10 maps to Drug/Alcohol Abuse, Without Dependence (HCC 56) with a community, non-dual, aged base RAF weight of 0.000. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
This code indicates abuse (problematic use) rather than dependence; if dependence is documented, use F14.2x codes instead. Because F14.10 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. 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, RAF weights, and MEAT documentation criteria for F14.10 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code indicates abuse (problematic use) rather than dependence; if dependence is documented, use F14.2x codes instead
- •Uncomplicated means no intoxication, withdrawal, or induced disorders are currently present
Clinical Significance
Cocaine abuse, uncomplicated, indicates a pattern of problematic cocaine use that does not yet meet criteria for dependence and has no current complications. Cocaine is a potent stimulant with significant cardiovascular, neurological, and psychiatric risks. Even uncomplicated abuse warrants intervention due to the high addictive potential and medical risks of cocaine use.
Documentation Requirements
- ✓Provider documentation explicitly stating 'cocaine abuse' or equivalent diagnostic language
- ✓Pattern of use meeting criteria for substance abuse (problematic use without dependence criteria)
- ✓Confirmation that no current intoxication, withdrawal, or induced disorders are present
- ✓Frequency and route of cocaine use if documented
- ✓Assessment for cardiovascular and psychiatric complications
- ✓Current treatment or intervention plan