F14.23
BillableCocaine dependence with withdrawal
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F14.23 an HCC code?
Yes. F14.23 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 F14.23
For F14.23 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 F14.23 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F14.23 is the ICD-10-CM diagnosis code for cocaine dependence with withdrawal. A person is dependent on cocaine and is experiencing withdrawal symptoms after stopping or reducing cocaine use. F14.23 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, F14.23 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, F14.23 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.
Cocaine withdrawal symptoms may include depression, fatigue, anhedonia, and increased appetite. Because F14.23 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 F14.23 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Cocaine withdrawal symptoms may include depression, fatigue, anhedonia, and increased appetite
- •Document the timeline and severity of withdrawal symptoms to support medical necessity for treatment
Clinical Significance
Cocaine dependence with withdrawal captures a clinically significant state where a dependent patient has stopped or reduced cocaine use and is experiencing withdrawal symptoms. Cocaine withdrawal primarily manifests as a severe 'crash' with profound dysphoria, anhedonia, fatigue, hypersomnia, and increased appetite. Unlike alcohol or benzodiazepine withdrawal, cocaine withdrawal is not typically life-threatening but carries significant suicide risk due to severe depression. The withdrawal phase is a critical treatment opportunity.
Documentation Requirements
- ✓Provider documentation of cocaine dependence (not abuse)
- ✓Documentation of recent cessation or significant reduction in cocaine use
- ✓Specific withdrawal symptoms described (dysphoria, fatigue, vivid unpleasant dreams, insomnia or hypersomnia, increased appetite, psychomotor retardation or agitation)
- ✓Timeline of symptom onset relative to last cocaine use
- ✓Suicide risk assessment given the depression associated with cocaine withdrawal
- ✓Treatment plan for managing withdrawal symptoms
Excludes 1 — Do NOT code together
- cocaine dependence with intoxication (F14.22-)