What is ICD-10 code F14.222?

F14.222 is the ICD-10-CM diagnosis code for Cocaine dependence with intoxication with perceptual disturbance. A person is dependent on cocaine and is currently intoxicated with distorted perceptions or hallucinations as a result of the drug use. F14.222 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. F14.222 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. F14.222 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. F14.222 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 F14.222?

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 F14.222, V28 maps to Drug Use Disorder/Substance Use Disorder, Moderate/Severe at RAF 0.358 while V24 mapped to Drug/Alcohol Dependence at RAF 0.334. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting F14.222?

This code requires documentation of both cocaine dependence and active intoxication with perceptual disturbances Perceptual disturbances may include visual, auditory, or tactile hallucinations during acute cocaine intoxication Because F14.222 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.

F14.222 ICD-10 Code: Cocaine dependence

ICD-10-CM Code View

HCC Buddy Code Card

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Code lookupF14.222Effective 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)

F14.222

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

Cocaine dependence with intoxication with perceptual disturbance

A person is dependent on cocaine and is currently intoxicated with distorted perceptions or hallucinations as a result of the drug use.

Buddy Insight

CMS-HCC V28

Mapped

HCC 137

Drug Use Disorder/Substance U...

RAF 0.358

CMS-HCC V24

Mapped

HCC 55

Drug/Alcohol Dependence

RAF 0.334

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Mapped

HCC 55

Drug/Alcohol Dependence

RAF 0.0

RXHCC

Not risk-adjusted for this model/period.

RAF 0

Code Trumping

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Code Book Path

Official

F14.2Cocaine dependence

F14.22Cocaine dependence with intoxication

F14.222Cocaine dependence with intoxication with perceptual disturbance

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for F14.222 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for F14.222 in this effective period.

Related Child Codes

Official

F14.220Cocaine dependence with intoxication, uncomplicated

F14.221Cocaine dependence with intoxication delirium

F14.229Cocaine dependence with intoxication, unspecified

Includes

Official

ICD-10-CM does not list Includes notes for F14.222 in this effective period.

Excludes 1

Official

cocaine dependence with withdrawal (F14.23)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for F14.222 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for F14.222 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for F14.222 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Provider documentation of cocaine dependence

Documentation of active intoxication at time of encounter

Specific description of perceptual disturbances (type and nature of sensory misperceptions)

Documentation confirming the disturbances are transient and related to intoxication (not a persistent psychotic disorder)

MEAT Support

HCC Buddy guidance

Provider documentation of cocaine dependence

Documentation of active intoxication at time of encounter

Specific description of perceptual disturbances (type and nature of sensory misperceptions)

Documentation confirming the disturbances are transient and related to intoxication (not a persistent psychotic disorder)

Audit Caution

HCC Buddy guidance

Confusing transient perceptual disturbance with cocaine-induced psychotic disorder

Using this code when the perceptual symptoms persist beyond the intoxication period (suggesting psychotic disorder instead)

Coding abuse when the pattern supports dependence

Not documenting the specific type of perceptual disturbance to support the code

Common Mistakes

HCC Buddy guidance

F14.220 — Cocaine dependence with intoxication, uncomplicated: use when NO perceptual disturbances are present

F14.221 — Cocaine dependence with intoxication delirium: use when acute confusion/disorientation is the primary feature

F14.251 — Cocaine dependence with cocaine-induced psychotic disorder with hallucinations: use when symptoms meet full psychotic disorder criteria beyond transient intoxication effects

F14.122 — Cocaine abuse with intoxication with perceptual disturbance: use when the pattern is abuse rather than dependence

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is F14.222 an HCC code?

Yes. F14.222 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

V28HCC 137, Drug Use Disorder/Substance Use Disorder, Moderate/Severe

0.358

V24HCC 55, Drug/Alcohol Dependence

0.334

ESRDHCC 55, Drug/Alcohol Dependence

0.000

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 F14.222

For F14.222to 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 F14.222 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

F14.222 is the ICD-10-CM diagnosis code for cocaine dependence with intoxication with perceptual disturbance. A person is dependent on cocaine and is currently intoxicated with distorted perceptions or hallucinations as a result of the drug use. F14.222 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, F14.222 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, F14.222 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.

This code requires documentation of both cocaine dependence and active intoxication with perceptual disturbances. Because F14.222 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 F14.222 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•This code requires documentation of both cocaine dependence and active intoxication with perceptual disturbances
•Perceptual disturbances may include visual, auditory, or tactile hallucinations during acute cocaine intoxication

Clinical Significance

Cocaine dependence with intoxication with perceptual disturbance indicates a dependent patient experiencing sensory misperceptions during acute intoxication, such as visual trails, tactile hallucinations (formication), or auditory disturbances. While less severe than full psychosis or delirium, perceptual disturbances indicate significant neurotoxicity and can escalate to more serious complications. This condition may require monitored observation and distinguishing from evolving psychosis.

Documentation Requirements

✓Provider documentation of cocaine dependence
✓Documentation of active intoxication at time of encounter
✓Specific description of perceptual disturbances (type and nature of sensory misperceptions)
✓Documentation confirming the disturbances are transient and related to intoxication (not a persistent psychotic disorder)
✓Vital signs and neurological assessment
✓Assessment distinguishing perceptual disturbance from delirium or psychosis

Commonly Confused Codes

•F14.220 — Cocaine dependence with intoxication, uncomplicated: use when NO perceptual disturbances are present
•F14.221 — Cocaine dependence with intoxication delirium: use when acute confusion/disorientation is the primary feature
•F14.251 — Cocaine dependence with cocaine-induced psychotic disorder with hallucinations: use when symptoms meet full psychotic disorder criteria beyond transient intoxication effects
•F14.122 — Cocaine abuse with intoxication with perceptual disturbance: use when the pattern is abuse rather than dependence
•F14.229 — Cocaine dependence with intoxication, unspecified: use when the type of intoxication complication is not specified