Skip to content
HCC Buddy home

F14.13 ICD-10-CM Code: Cocaine abuse, unspecified with withdrawal

F14.13 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 · free HCC coding tools

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupF14.13

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

F14.13

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

Cocaine abuse, unspecified with withdrawal

A person abuses cocaine and is experiencing withdrawal symptoms after stopping or reducing cocaine use.

Buddy the Bee presenting code insight

Buddy Insight

Cocaine abuse with withdrawal captures a critical clinical state where the patient has reduced or stopped cocaine use and is experiencing withdrawal symptoms such as severe depression, fatigue, anhedonia, increased appetite, and psychomotor retardation.

OverviewRisk ModelsCode BookDocumentationAuditNotesEdition comparison

CMS-HCC V28

HCC 137

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

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

HCC 082

Code-level coefficient reference

ESRD/PACE

HCC 55

Code-level coefficient reference

RXHCC

N/A

—

Not mapped

Code Book Path

Official
F14Cocaine related disordersF14.1Cocaine abuseF14.13Cocaine abuse, unspecified with withdrawal

Inclusion Terms

Official

No inclusion terms are included in this display for F14.13. Check the code and parent instructions in the Code Book.

Excludes 2

Official
  • symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99)Inherited from F01-F99, F14
  • other stimulant-related disorders (F15.-)Inherited from F01-F99, F14

Related Codes

Official
F14.10Cocaine abuse, uncomplicatedF14.11Cocaine abuse, in remissionF14.12Cocaine abuse with intoxicationF14.14Cocaine abuse with cocaine-induced mood disorderF14.15Cocaine abuse with cocaine-induced psychotic disorder

Includes

Official
  • disorders of psychological developmentInherited from F01-F99

Excludes 1

Official
  • cocaine dependence (F14.2-)Inherited from F14.1
  • cocaine use, unspecified (F14.9-)Inherited from F14.1

Code First

Official

No Code First sequencing instructions are included in this display for F14.13. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for F14.13. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for F14.13. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance
Provider must document cocaine as the specific substance of abuse
Abuse pattern (not dependence) must be established per DSM-5 criteria
Documentation of recent cessation or significant reduction in cocaine use
Specific withdrawal symptoms must be described (e.g., dysphoria, fatigue, vivid unpleasant dreams, insomnia or hypersomnia, increased appetite, psychomotor retardation or agitation)

MEAT Support

HCC Buddy guidance
Provider must document cocaine as the specific substance of abuse
Abuse pattern (not dependence) must be established per DSM-5 criteria
Documentation of recent cessation or significant reduction in cocaine use
Specific withdrawal symptoms must be described (e.g., dysphoria, fatigue, vivid unpleasant dreams, insomnia or hypersomnia, increased appetite, psychomotor retardation or agitation)

Audit Caution

HCC Buddy guidance
Coding withdrawal when the patient is still actively using cocaine (withdrawal requires cessation or reduction)
Confusing cocaine withdrawal symptoms (primarily psychological) with opioid or alcohol withdrawal (primarily physical)
Failing to differentiate abuse from dependence, which changes the code to F14.23
Not documenting the specific withdrawal symptoms, making the code unsupportable on audit

Common Mistakes

HCC Buddy guidance
F14.23 — Cocaine dependence with withdrawal: use when the substance use pattern meets dependence rather than abuse criteria
F14.14 — Cocaine abuse with cocaine-induced mood disorder: use when the mood disturbance is the primary induced condition rather than a general withdrawal state
F14.120 — Cocaine abuse with intoxication, uncomplicated: opposite clinical scenario; intoxication is active use, withdrawal is after cessation
F14.10 — Cocaine abuse, uncomplicated: use when no intoxication, withdrawal, or induced disorders are present

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 F14.13 an HCC code?

Yes. F14.13 (Cocaine abuse, unspecified with withdrawal) 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: F14.13 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
F14.13
Description
Cocaine abuse, unspecified with withdrawal
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 F14.13 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for F14.13

For F14.13, 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

Get the V28 mapping + MEAT cheat sheet

One printable reference: check representative V28 mappings and the documentation reminders your note needs. Free, no card.

Free PDF. No card. Unsubscribe anytime.

What This Code Means

F14.13 is the ICD-10-CM diagnosis code for cocaine abuse, unspecified with withdrawal. A person abuses cocaine and is experiencing withdrawal symptoms after stopping or reducing cocaine use. F14.13 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, F14.13 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. No V24 mapping is shown for F14.13; use the applicable model and payment year when reviewing the V28 mapping. 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.

Document specific withdrawal symptoms (depression, fatigue, anhedonia, etc.) as cocaine withdrawal can present with various symptoms. For F14.13, 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 F14.13 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Document specific withdrawal symptoms (depression, fatigue, anhedonia, etc.) as cocaine withdrawal can present with various symptoms
  • •Withdrawal indicates the person has stopped using cocaine; if they are still actively using, this code would not apply

Clinical Significance

Cocaine abuse with withdrawal captures a critical clinical state where the patient has reduced or stopped cocaine use and is experiencing withdrawal symptoms such as severe depression, fatigue, anhedonia, increased appetite, and psychomotor retardation. This diagnosis is significant because cocaine withdrawal, while not typically life-threatening like alcohol or benzodiazepine withdrawal, carries substantial suicide risk due to the profound dysphoria. It also indicates the patient's use pattern is severe enough to produce physiological adaptation.

Documentation Requirements

  • ✓Provider must document cocaine as the specific substance of abuse
  • ✓Abuse pattern (not dependence) must be established per DSM-5 criteria
  • ✓Documentation of recent cessation or significant reduction in cocaine use
  • ✓Specific withdrawal symptoms must be described (e.g., dysphoria, fatigue, vivid unpleasant dreams, insomnia or hypersomnia, increased appetite, psychomotor retardation or agitation)
  • ✓Temporal relationship between stopping cocaine and symptom onset
  • ✓Assessment of suicide risk given the depression associated with cocaine withdrawal

Commonly Confused Codes

  • •F14.23: Cocaine dependence with withdrawal: use when the substance use pattern meets dependence rather than abuse criteria
  • •F14.14: Cocaine abuse with cocaine-induced mood disorder: use when the mood disturbance is the primary induced condition rather than a general withdrawal state
  • •F14.120: Cocaine abuse with intoxication, uncomplicated: opposite clinical scenario; intoxication is active use, withdrawal is after cessation
  • •F14.10: Cocaine abuse, uncomplicated: use when no intoxication, withdrawal, or induced disorders are present

Child Codes

F14.10Cocaine abuse, uncomplicated
HCC 138
F14.11Cocaine abuse, in remission
HCC 138
F14.12Cocaine abuse with intoxication
F14.13Cocaine abuse, unspecified with withdrawal
HCC 137
F14.14Cocaine abuse with cocaine-induced mood disorder
HCC 137
F14.15Cocaine abuse with cocaine-induced psychotic disorder
F14.18Cocaine abuse with other cocaine-induced disorder
F14.19Cocaine abuse with unspecified cocaine-induced disorder
HCC 137

Code Hierarchy

└F14Cocaine related disorders└F14.1Cocaine abuse└F14.13Cocaine abuse, unspecified with withdrawal
└F14.13Cocaine abuse, unspecified with withdrawal

F14.13 code history

Code setChange
FY2021 (effective Oct 1, 2020)Added to the code set

Source: official CMS ICD-10-CM order and addenda files, FY2016 through FY2027.

Also searched as

  • F14 13
  • F1413

For F14.13, 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.

F14.13 maps to CMS-HCC V28 category 137, Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. The mapping identifies a payment HCC category for F14.13. Review its source-labeled HCC coefficient above, check the RAF Calculator with complete member context for CMS-HCC V28 PY2026, and confirm the documentation the chart needs before the code is submitted. HCC Buddy shows no RAF score unless every required source and calculation check passes.

Work F14.13 in HCC Buddy

Open F14.13 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.

Open in Code BookOpen in EncoderStart Pro