F14.188
BillableCocaine abuse with other cocaine-induced disorder
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F14.188 an HCC code?
Yes. F14.188 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 F14.188
For F14.188 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 F14.188 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F14.188 is the ICD-10-CM diagnosis code for cocaine abuse with other cocaine-induced disorder. This code describes a patient who misuses cocaine and has developed another cocaine-related medical or psychiatric condition beyond just the substance use itself, such as sleep problems, anxiety, or other health effects caused by the drug. It indicates problematic cocaine use that has led to additional health complications. F14.188 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, F14.188 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, F14.188 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.
Verify documentation specifies both cocaine abuse AND an additional cocaine-induced condition (such as F14.188 for sleep disorder, anxiety, or other specified disorder) rather than just cocaine use alone. Because F14.188 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 F14.188 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify documentation specifies both cocaine abuse AND an additional cocaine-induced condition (such as F14.188 for sleep disorder, anxiety, or other specified disorder) rather than just cocaine use alone
- •Do not use this code if the patient has cocaine dependence instead of abuse; dependence requires codes from the F14.2x series, while abuse uses F14.1x series
Clinical Significance
Cocaine abuse with other cocaine-induced disorder is a residual category for cocaine-induced conditions that do not fit the specific subcategories (mood, anxiety, psychosis, sexual dysfunction, or sleep disorders). This may include cocaine-induced obsessive-compulsive disorder, cognitive impairment, or other neuropsychiatric conditions. The code reflects that cocaine's widespread effects on the central nervous system can produce varied clinical presentations beyond the standard categories.
Documentation Requirements
- ✓Provider documentation of cocaine abuse (not dependence)
- ✓Specific description of the cocaine-induced disorder present
- ✓Documentation that the disorder is directly caused by cocaine use
- ✓Explanation of why the condition does not fit more specific F14.18x subcategories
- ✓Temporal relationship between cocaine use and onset of the induced disorder
- ✓Clinical impact of the induced disorder on patient functioning
Commonly Confused Codes
- •F14.180 — Cocaine abuse with cocaine-induced anxiety disorder: use when anxiety is the specific induced condition
- •F14.181 — Cocaine abuse with cocaine-induced sexual dysfunction: use when sexual dysfunction is specifically documented
- •F14.182 — Cocaine abuse with cocaine-induced sleep disorder: use when sleep disorder is the specific condition
- •F14.19 — Cocaine abuse with unspecified cocaine-induced disorder: use when the specific disorder cannot be identified at all
- •F14.288 — Cocaine dependence with other cocaine-induced disorder: use when the pattern is dependence