What is ICD-10 code F14.20?

F14.20 is the ICD-10-CM diagnosis code for Cocaine dependence, uncomplicated. It belongs to the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99). F14.20 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. F14.20 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. F14.20 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. F14.20 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.

What is the V28 vs V24 difference for F14.20?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For F14.20, V28 maps to Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications at RAF 0.424 while V24 mapped to Substance Use Disorder, Moderate/Severe, or Substance Use with Complications at RAF 0.329. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting F14.20?

Cocaine dependence, uncomplicated. Documented dependence, tolerance, craving, loss of control, without acute intoxication or withdrawal at the current encounter. Do not report F14.20 alongside F14.21 (in remission), status determines the code. Also, cocaine dependence is clinically distinct from stimulant dependence (F15.20); verify the substance. V28 HCC 137 (Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications) at RAF 0.424. Accurate dependence-vs-abuse distinction matters for RAF (HCC 137 vs the mild HCC 138). Because F14.20 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

2026 ICD-10-CM F14.20: Cocaine dependence

ICD-10-CM Code View

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Code lookupF14.20Effective 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)

F14.20

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

Cocaine dependence, uncomplicated

This code describes a person who is dependent on cocaine but does not currently have any complications from their addiction, such as withdrawal symptoms or related medical conditions. It indicates an ongoing substance use disorder without acute medical or psychiatric complications at the time of diagnosis.

Buddy Insight

CMS-HCC V28

Mapped

HCC 137

Drug Use Disorder, Moderate/S...

RAF 0.424

CMS-HCC V24

Mapped

HCC 55

Substance Use Disorder, Moder...

RAF 0.329

ACA/HHS

Mapped

HCC 82

HHS-HCC 82

Varies by metal level

ESRD/PACE

Mapped

HCC 55

Substance Use Disorder, Moder...

RAF 0.111

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

F14Cocaine related disorders

F14.2Cocaine dependence

F14.20Cocaine dependence, uncomplicated

Inclusion Terms

Official

Cocaine use disorder, moderate
Cocaine use disorder, severe

Excludes 2

Official

cocaine poisoning (T40.5-)

Related Child Codes

Official

F14.21Cocaine dependence, in remission

F14.22Cocaine dependence with intoxication

F14.23Cocaine dependence with withdrawal

F14.24Cocaine dependence with cocaine-induced mood disorder

F14.25Cocaine dependence with cocaine-induced psychotic disorder

Includes

Official

ICD-10-CM does not list Includes notes for F14.20 in this effective period.

Excludes 1

Official

cocaine abuse (F14.1-)
cocaine use, unspecified (F14.9-)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for F14.20 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for F14.20 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for F14.20 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Provider must explicitly document cocaine dependence or use language consistent with dependence (addiction, moderate-to-severe use disorder)

Clinical criteria for dependence must be met: tolerance, withdrawal history, continued use despite problems, inability to cut down, or craving

Documentation confirming no current intoxication, withdrawal, or induced disorders at the time of encounter

Current status of the dependence (active use vs. maintained on treatment)

MEAT Support

HCC Buddy guidance

Provider must explicitly document cocaine dependence or use language consistent with dependence (addiction, moderate-to-severe use disorder)

Clinical criteria for dependence must be met: tolerance, withdrawal history, continued use despite problems, inability to cut down, or craving

Documentation confirming no current intoxication, withdrawal, or induced disorders at the time of encounter

Current status of the dependence (active use vs. maintained on treatment)

Audit Caution

HCC Buddy guidance

Coding dependence when documentation only supports abuse (lower severity)

Using this uncomplicated code when the patient has concurrent intoxication, withdrawal, or induced disorders

Failing to reassess dependence status at each encounter (patient may be in remission)

Confusing 'history of' cocaine use with active dependence — history codes are coded differently

Common Mistakes

HCC Buddy guidance

F14.10 — Cocaine abuse, uncomplicated: lower severity; abuse does not meet dependence criteria

F14.21 — Cocaine dependence, in remission: use when the patient is in recovery and not currently meeting dependence criteria

F14.20 vs. F14.220 — Cocaine dependence with intoxication, uncomplicated: use F14.220 when the patient is currently intoxicated

F14.23 — Cocaine dependence with withdrawal: use when withdrawal symptoms are present

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 F14.20 an HCC code?

Yes. F14.20 (Cocaine dependence, uncomplicated) maps to Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications under the CMS-HCC V28 risk adjustment model (and Substance Use Disorder, Moderate/Severe, or Substance Use with Complications under V24), with a community non-dual aged RAF of 0.424. It is billable for payment year 2026.

Coder answer: F14.20 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: F14.20
Description: Cocaine dependence, uncomplicated
HCC (V28): HCC 137 — Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
RAF: 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

V24HCC 55, Substance Use Disorder, Moderate/Severe, or Substance Use with Complications

0.329

ESRDHCC 55, Substance Use Disorder, Moderate/Severe, or Substance Use with Complications

0.111

Each model's RAF is its CMS base weight for that model's standard population, so 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 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.

Work F14.20 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for F14.20

For F14.20 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 F14.20 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

F14.20 is the ICD-10-CM diagnosis code for cocaine dependence, uncomplicated. This code describes a person who is dependent on cocaine but does not currently have any complications from their addiction, such as withdrawal symptoms or related medical conditions. It indicates an ongoing substance use disorder without acute medical or psychiatric complications at the time of diagnosis. F14.20 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, F14.20 maps to Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications (HCC 137) with a community, non-dual, aged base RAF weight of 0.424. Under the older CMS-HCC V24 model, F14.20 maps to Substance Use Disorder, Moderate/Severe, or Substance Use with Complications (HCC 55) with a community, non-dual, aged base RAF weight of 0.329. 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.

Cocaine dependence, uncomplicated. Documented dependence, tolerance, craving, loss of control, without acute intoxication or withdrawal at the current encounter. Because F14.20 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 F14.20 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Cocaine dependence, uncomplicated. Documented dependence, tolerance, craving, loss of control, without acute intoxication or withdrawal at the current encounter.
•Do not report F14.20 alongside F14.21 (in remission), status determines the code. Also, cocaine dependence is clinically distinct from stimulant dependence (F15.20); verify the substance.
•V28 HCC 137 (Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications) at RAF 0.424. Accurate dependence-vs-abuse distinction matters for RAF (HCC 137 vs the mild HCC 138).

Clinical Significance

Cocaine dependence, uncomplicated indicates a patient who meets DSM-5 criteria for cocaine use disorder at a moderate to severe level (dependence) but is not currently experiencing intoxication, withdrawal, or any cocaine-induced complications. This is a chronic, relapsing condition with significant morbidity related to cardiovascular disease, neurological damage, and psychiatric comorbidities. Accurate capture is important as it represents ongoing care needs and higher predicted healthcare utilization than cocaine abuse.

Documentation Requirements

✓Provider must explicitly document cocaine dependence or use language consistent with dependence (addiction, moderate-to-severe use disorder)
✓Clinical criteria for dependence must be met: tolerance, withdrawal history, continued use despite problems, inability to cut down, or craving
✓Documentation confirming no current intoxication, withdrawal, or induced disorders at the time of encounter
✓Current status of the dependence (active use vs. maintained on treatment)
✓Treatment plan including any pharmacotherapy or behavioral interventions

Commonly Confused Codes

•F14.10: Cocaine abuse, uncomplicated: lower severity; abuse does not meet dependence criteria
•F14.21: Cocaine dependence, in remission: use when the patient is in recovery and not currently meeting dependence criteria
•F14.20 vs. F14.220: Cocaine dependence with intoxication, uncomplicated: use F14.220 when the patient is currently intoxicated
•F14.23: Cocaine dependence with withdrawal: use when withdrawal symptoms are present
•F14.90: Cocaine use, unspecified, uncomplicated: use when abuse vs. dependence cannot be determined