F14.220
BillableCocaine dependence with intoxication, uncomplicated
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F14.220 an HCC code?
Yes. F14.220 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 F14.220
For F14.220 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 F14.220 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F14.220 is the ICD-10-CM diagnosis code for cocaine dependence with intoxication, uncomplicated. A person who is dependent on cocaine and is currently intoxicated from cocaine use, without additional complications like confusion or delirium. F14.220 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, F14.220 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, F14.220 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.
Distinguish from F14.221 by confirming that delirium is NOT present. Because F14.220 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 F14.220 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Distinguish from F14.221 by confirming that delirium is NOT present
- •Document the current intoxication state and confirm dependence status (not abuse)
Clinical Significance
Cocaine dependence with intoxication, uncomplicated captures an encounter where a cocaine-dependent patient is currently intoxicated but without severe complications such as delirium or perceptual disturbance. This represents a clinical situation requiring monitoring for cardiovascular complications (hypertensive crisis, arrhythmias, myocardial infarction), seizures, and behavioral instability. The combination of dependence and active intoxication suggests the patient's use disorder is not controlled.
Documentation Requirements
- ✓Provider documentation of cocaine dependence (not abuse)
- ✓Documentation of current intoxication at the time of encounter
- ✓Clinical signs of intoxication (euphoria, hyperactivity, dilated pupils, tachycardia, hypertension)
- ✓Confirmation that no complications (delirium, perceptual disturbances) are present
- ✓Vital signs and cardiac monitoring documented
- ✓Assessment of safety and disposition planning