What is ICD-10 code F14.181?

F14.181 is the ICD-10-CM diagnosis code for Cocaine abuse with cocaine-induced sexual dysfunction. A person who abuses cocaine and experiences sexual dysfunction (difficulty with sexual performance or desire) caused by the cocaine use. It belongs to the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99). F14.181 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. F14.181 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. F14.181 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. F14.181 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does F14.181 map to under V28?

F14.181 maps to CMS-HCC V28 HCC 137 (Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications). The category numbers, labels, and conditions come from the CMS-HCC V28 model file for payment year 2026.

2026 ICD-10-CM F14.181: Cocaine abuse

F14.181 maps to CMS-HCC V28 137. A source-labeled RAF reference is available. Documentation must support MEAT. 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 lookupF14.181Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

F14.181

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

Cocaine abuse with cocaine-induced sexual dysfunction

A person who abuses cocaine and experiences sexual dysfunction (difficulty with sexual performance or desire) caused by the cocaine use.

Buddy Insight

CMS-HCC V28

Mapped

HCC 137

Drug Use Disorder, Moderate/S...

Code-level coefficient reference

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

Mapped

HCC 082

HHS-HCC 082 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 55

Substance Use Disorder/Modera...

Code-level coefficient reference

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

F14.1Cocaine abuse

F14.18Cocaine abuse with other cocaine-induced disorder

F14.181Cocaine abuse with cocaine-induced sexual dysfunction

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for F14.181 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for F14.181 in this effective period.

Related Child Codes

Official

F14.180Cocaine abuse with cocaine-induced anxiety disorder

F14.182Cocaine abuse with cocaine-induced sleep disorder

F14.188Cocaine abuse with other cocaine-induced disorder

Includes

Official

ICD-10-CM does not list Includes notes for F14.181 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for F14.181 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for F14.181 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for F14.181 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for F14.181 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Provider documentation of cocaine abuse pattern

Specific documentation of sexual dysfunction type (erectile dysfunction, decreased libido, anorgasmia, etc.)

Clear causal relationship established between cocaine use and sexual dysfunction

Documentation ruling out other medical causes of sexual dysfunction (diabetes, hypertension, medications)

MEAT Support

HCC Buddy guidance

Provider documentation of cocaine abuse pattern

Specific documentation of sexual dysfunction type (erectile dysfunction, decreased libido, anorgasmia, etc.)

Clear causal relationship established between cocaine use and sexual dysfunction

Documentation ruling out other medical causes of sexual dysfunction (diabetes, hypertension, medications)

Audit Caution

HCC Buddy guidance

Attributing sexual dysfunction to cocaine when other medical causes are more likely

Using generic sexual dysfunction codes instead of this combination code when cocaine is the documented cause

Failing to document the specific type of sexual dysfunction

Not distinguishing between abuse and dependence patterns

Common Mistakes

HCC Buddy guidance

F14.281 — Cocaine dependence with cocaine-induced sexual dysfunction: use when the substance use pattern is dependence

N52.9 — Male erectile dysfunction, unspecified: use when erectile dysfunction is not related to cocaine use

F52.0 — Hypoactive sexual desire disorder: use when decreased libido is a primary condition

F14.188 — Cocaine abuse with other cocaine-induced disorder: use when the cocaine-induced condition does not fit specific subcategories

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 F14.181 an HCC code?

Yes. F14.181 (Cocaine abuse with cocaine-induced sexual dysfunction) 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: F14.181 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: F14.181
Description: Cocaine abuse with cocaine-induced sexual dysfunction
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 F14.181 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT Criteria for F14.181

For F14.181 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 F14.181 during that encounter, not just copy-forwarded from a problem list.

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

F14.181 is the ICD-10-CM diagnosis code for cocaine abuse with cocaine-induced sexual dysfunction. A person who abuses cocaine and experiences sexual dysfunction (difficulty with sexual performance or desire) caused by the cocaine use. F14.181 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, F14.181 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 F14.181; use the applicable model and payment year when reviewing the V28 mapping. 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. 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 should clearly link sexual dysfunction to cocaine abuse rather than other medical or psychological causes. Because F14.181 maps to an HCC category, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) before the diagnosis is used for risk adjustment. 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 F14.181 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Document should clearly link sexual dysfunction to cocaine abuse rather than other medical or psychological causes
•This is a specific cocaine-induced disorder distinct from general sexual dysfunction codes

Clinical Significance

Cocaine abuse with cocaine-induced sexual dysfunction captures the impact of cocaine on sexual health, including erectile dysfunction, decreased libido, delayed ejaculation, or anorgasmia resulting from cocaine's effects on dopamine pathways and vascular function. This is clinically relevant because sexual dysfunction often contributes to relationship distress and may be a motivating factor for treatment engagement. Chronic cocaine use can cause both acute and long-term sexual dysfunction through neurotransmitter depletion and vascular damage.

Documentation Requirements

✓Provider documentation of cocaine abuse pattern
✓Specific documentation of sexual dysfunction type (erectile dysfunction, decreased libido, anorgasmia, etc.)
✓Clear causal relationship established between cocaine use and sexual dysfunction
✓Documentation ruling out other medical causes of sexual dysfunction (diabetes, hypertension, medications)
✓Timeline showing sexual dysfunction onset relative to cocaine use pattern
✓Patient's subjective report of sexual difficulties

Commonly Confused Codes

•F14.281: Cocaine dependence with cocaine-induced sexual dysfunction: use when the substance use pattern is dependence
•N52.9: Male erectile dysfunction, unspecified: use when erectile dysfunction is not related to cocaine use
•F52.0: Hypoactive sexual desire disorder: use when decreased libido is a primary condition
•F14.188: Cocaine abuse with other cocaine-induced disorder: use when the cocaine-induced condition does not fit specific subcategories
•F14.981: Cocaine use, unspecified with cocaine-induced sexual dysfunction: use when abuse vs. dependence is unclear