F14.129
BillableCocaine abuse with intoxication, unspecified
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F14.129 an HCC code?
Yes. F14.129 maps to Drug Use Disorder/Substance Use Disorder, Moderate/Severe under the CMS-HCC V28 risk adjustment model (and Drug/Alcohol 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 F14.129
For F14.129 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 F14.129 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F14.129 is the ICD-10-CM diagnosis code for cocaine abuse with intoxication, unspecified. A person abuses cocaine and is currently intoxicated, but the specific symptoms or complications of the intoxication are not specified. F14.129 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, F14.129 maps to Drug Use Disorder/Substance Use Disorder, Moderate/Severe (HCC 137) with a community, non-dual, aged base RAF weight of 0.358. Under the older CMS-HCC V24 model, F14.129 maps to Drug/Alcohol Dependence (HCC 55) with a community, non-dual, aged base RAF weight of 0.334. 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.
Use this code when intoxication is documented but delirium or perceptual disturbances are not specifically mentioned. Because F14.129 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 F14.129 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
Clinical Significance
This code captures cocaine abuse with intoxication where the specific type of intoxication complication is not documented. It reflects an encounter where the patient is actively intoxicated from cocaine but the provider has not specified whether delirium, perceptual disturbance, or no complications are present. Clinically, any cocaine intoxication warrants monitoring for cardiovascular complications, seizures, and behavioral instability. This unspecified code represents a missed opportunity for more precise documentation.
Documentation Requirements
- ✓Provider documentation of cocaine as the substance of abuse
- ✓Clinical pattern consistent with abuse (not dependence) per DSM-5 criteria
- ✓Documentation of active intoxication at the time of the encounter
- ✓Clinical signs of intoxication (tachycardia, hypertension, euphoria, agitation, dilated pupils)
- ✓Statement that specific complications of intoxication are not further specified or cannot be determined