F14.181
BillableCocaine abuse with cocaine-induced sexual dysfunction
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F14.181 an HCC code?
Yes. F14.181 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 F14.181
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.
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/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, F14.181 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.
Document should clearly link sexual dysfunction to cocaine abuse rather than other medical or psychological causes. Because F14.181 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 F14.181 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