F14.151 ICD-10-CM Code: Cocaine abuse with cocaine-induced psychotic disorder with hallucinations
F14.151 maps to CMS-HCC V28 135. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · free HCC coding tools
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FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Mental and behavioral disorders due to psychoactive substance use (F10-F19)
F14.151
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceCocaine abuse with cocaine-induced psychotic disorder with hallucinations
A person who abuses cocaine and experiences psychotic symptoms, specifically seeing or hearing things that aren't real (hallucinations) caused by the cocaine use.
Buddy Insight
Cocaine abuse with cocaine-induced psychotic disorder with hallucinations indicates the patient is experiencing sensory perceptions without external stimuli, directly caused by cocaine use.
CMS-HCC V28
MappedHCC 135
Coefficient HCC 135: 0.424 (Community Non-Dual Aged (CNA))
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
MappedHCC 081
Code-level coefficient reference
ESRD/PACE
MappedHCC 54
Code-level coefficient reference
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for F14.151. 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
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
OfficialNo Code First sequencing instructions are included in this display for F14.151. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for F14.151. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for F14.151. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 F14.151 an HCC code?
Yes. F14.151 (Cocaine abuse with cocaine-induced psychotic disorder with hallucinations) maps to HCC 135, Drug Use with 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: F14.151 is billable and maps to V28 HCC 135, Drug Use with Psychotic Complications. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.
- Code
- F14.151
- Description
- Cocaine abuse with cocaine-induced psychotic disorder with hallucinations
- HCC (V28)
- HCC 135 — Drug Use with Psychotic Complications
- RAF reference coefficient
- 0.424
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
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 F14.151 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for F14.151
For F14.151, 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
F14.151 is the ICD-10-CM diagnosis code for cocaine abuse with cocaine-induced psychotic disorder with hallucinations. A person who abuses cocaine and experiences psychotic symptoms, specifically seeing or hearing things that aren't real (hallucinations) caused by the cocaine use. F14.151 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, F14.151 maps to Drug Use with Psychotic Complications (HCC 135) 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.
Ensure documentation specifies hallucinations as the primary psychotic symptom and links them to cocaine abuse. For F14.151, 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 F14.151 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Ensure documentation specifies hallucinations as the primary psychotic symptom and links them to cocaine abuse
- •Distinguish from delusions (F14.150) by confirming the type of psychotic manifestation
Clinical Significance
Cocaine abuse with cocaine-induced psychotic disorder with hallucinations indicates the patient is experiencing sensory perceptions without external stimuli, directly caused by cocaine use. Cocaine-induced hallucinations are often tactile (formication or 'coke bugs'), visual, or auditory, and distinguish this from the more benign perceptual disturbances seen during simple intoxication. This represents a serious psychiatric emergency that may require acute stabilization and carries risk for self-injurious behavior driven by hallucinatory experiences.
Documentation Requirements
- ✓Provider documentation of cocaine abuse (not dependence) pattern
- ✓Clear documentation that the psychotic disorder is cocaine-induced
- ✓Description of the type of hallucinations (visual, auditory, tactile, olfactory)
- ✓Documentation excluding primary psychotic disorders as the etiology
- ✓Temporal relationship between cocaine use and hallucination onset
- ✓Mental status examination documenting hallucinatory experiences
- ✓Safety assessment regarding response to hallucinations
Commonly Confused Codes
- •F14.150: Cocaine abuse with cocaine-induced psychotic disorder with delusions: use when primary psychotic symptom is false beliefs rather than hallucinations
- •F14.122: Cocaine abuse with intoxication with perceptual disturbance: use for less severe sensory misperceptions during intoxication that do not constitute a full psychotic disorder
- •F14.251: Cocaine dependence with cocaine-induced psychotic disorder with hallucinations: use when the pattern is dependence rather than abuse
- •F14.159: Cocaine abuse with cocaine-induced psychotic disorder, unspecified: use when the specific psychotic symptom type is not documented
- •F20.x: Schizophrenia: use only when hallucinations are from a primary psychotic disorder, not substance-induced