F14.151
BillableCocaine abuse with cocaine-induced psychotic disorder with hallucinations
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F14.151 an HCC code?
Yes. F14.151 maps to Drug/Alcohol Psychosis under the CMS-HCC V28 risk adjustment model (and Drug/Alcohol Psychosis 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 F14.151
For F14.151 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 F14.151 during that encounter — not just copy-forwarded from a problem list.
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/Alcohol Psychosis (HCC 135) with a community, non-dual, aged base RAF weight of 0.000. Under the older V24 model, F14.151 mapped to the same category but with a base RAF weight of 0.434 — V28 recalibrated weights across the entire model. 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.
Ensure documentation specifies hallucinations as the primary psychotic symptom and links them to cocaine abuse. Because F14.151 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 F14.151 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