What is ICD-10 code F14.250?

F14.250 is the ICD-10-CM diagnosis code for Cocaine dependence with cocaine-induced psychotic disorder with delusions. A person is dependent on cocaine and is experiencing psychosis with delusions (false beliefs) caused by the cocaine use. It belongs to the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99). F14.250 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. F14.250 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. F14.250 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. F14.250 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.

Which HCC does F14.250 map to under V28?

F14.250 maps to CMS-HCC V28 HCC 135 (Drug Use with Psychotic Complications). The category numbers, labels, and conditions come from the CMS-HCC V28 model file for payment year 2026.

2026 ICD-10-CM F14.250: Cocaine dependence

F14.250 maps to CMS-HCC V28 135. A source-labeled RAF reference is available. Documentation must support MEAT. MEAT criteria · RAF Calculator · free HCC coding tools

ICD-10-CM Code View

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Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupF14.250Effective 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)

F14.250

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

Cocaine dependence with cocaine-induced psychotic disorder with delusions

A person is dependent on cocaine and is experiencing psychosis with delusions (false beliefs) caused by the cocaine use.

Buddy Insight

Cocaine dependence with cocaine-induced psychotic disorder with delusions is a high-acuity condition where a cocaine-dependent patient develops fixed false beliefs directly caused by cocaine use.

CMS-HCC V28

Mapped

HCC 135

Drug Use with Psychotic Compl...

Code-level coefficient reference

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

Mapped

HCC 081

HHS-HCC 081 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 54

Substance Use with Psychotic ...

Code-level coefficient reference

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

F14.2Cocaine dependence

F14.25Cocaine dependence with cocaine-induced psychotic disorder

F14.250Cocaine dependence with cocaine-induced psychotic disorder with delusions

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for F14.250 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for F14.250 in this effective period.

Related Child Codes

Official

F14.251Cocaine dependence with cocaine-induced psychotic disorder with hallucinations

F14.259Cocaine dependence with cocaine-induced psychotic disorder, unspecified

Includes

Official

ICD-10-CM does not list Includes notes for F14.250 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for F14.250 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for F14.250 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for F14.250 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for F14.250 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Provider documentation of cocaine dependence

Clear documentation that the psychotic disorder is cocaine-induced

Specific description of delusions (paranoid, grandiose, referential, persecutory)

Mental status examination documenting delusional thinking

MEAT Support

HCC Buddy guidance

Provider documentation of cocaine dependence

Clear documentation that the psychotic disorder is cocaine-induced

Specific description of delusions (paranoid, grandiose, referential, persecutory)

Mental status examination documenting delusional thinking

Audit Caution

HCC Buddy guidance

Failing to distinguish cocaine-induced psychosis from primary psychotic disorders

Confusing transient perceptual disturbances during intoxication with a full psychotic disorder

Not specifying the type of psychotic symptom (delusions vs. hallucinations) when documentation supports it

Using abuse codes when the pattern meets dependence criteria

Common Mistakes

HCC Buddy guidance

F14.251 — Cocaine dependence with cocaine-induced psychotic disorder with hallucinations: use when hallucinations are the primary psychotic symptom

F14.259 — Cocaine dependence with cocaine-induced psychotic disorder, unspecified: use when the type of psychosis is not specified

F14.150 — Cocaine abuse with cocaine-induced psychotic disorder with delusions: use when the pattern is abuse

F14.222 — Cocaine dependence with intoxication with perceptual disturbance: use for transient perceptual changes not meeting psychosis criteria

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 F14.250 an HCC code?

Yes. F14.250 (Cocaine dependence with cocaine-induced psychotic disorder with delusions) maps to HCC 135, Drug Use with Psychotic Complications under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.424. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: F14.250 is billable and maps to V28 HCC 135, Drug Use with Psychotic Complications. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: F14.250
Description: Cocaine dependence with cocaine-induced psychotic disorder with delusions
HCC (V28): HCC 135 — Drug Use with Psychotic Complications
RAF reference coefficient: 0.424
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 135, Drug Use with Psychotic Complications

0.424

ESRDHCC 54, Substance Use with Psychotic Complications

Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. 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 context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work F14.250 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT Criteria for F14.250

For F14.250 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 F14.250 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

F14.250 is the ICD-10-CM diagnosis code for cocaine dependence with cocaine-induced psychotic disorder with delusions. A person is dependent on cocaine and is experiencing psychosis with delusions (false beliefs) caused by the cocaine use. F14.250 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, F14.250 maps to Drug Use with Psychotic Complications (HCC 135) with a source-labeled community, non-dual, aged reference coefficient of 0.424. No V24 mapping is shown for F14.250; use the applicable model and payment year when reviewing the V28 mapping. 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. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

Document the specific nature of delusions (paranoid, grandiose, etc.) when possible. Because F14.250 maps to an HCC category, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) before the diagnosis is used for risk adjustment. 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, source-labeled coefficient references, and MEAT documentation criteria for F14.250 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Document the specific nature of delusions (paranoid, grandiose, etc.) when possible
•Distinguish between cocaine-induced psychosis and primary psychotic disorders in the medical record

Clinical Significance

Cocaine dependence with cocaine-induced psychotic disorder with delusions is a high-acuity condition where a cocaine-dependent patient develops fixed false beliefs directly caused by cocaine use. Cocaine-induced paranoid delusions are particularly common and can lead to violent behavior, resistance to treatment, and psychiatric hospitalization. This represents the most severe end of the cocaine-related mental health spectrum and requires aggressive psychiatric intervention alongside substance use treatment.

Documentation Requirements

✓Provider documentation of cocaine dependence
✓Clear documentation that the psychotic disorder is cocaine-induced
✓Specific description of delusions (paranoid, grandiose, referential, persecutory)
✓Mental status examination documenting delusional thinking
✓Documentation ruling out primary psychotic disorders (Schizophrenia, Schizoaffective Disorder)
✓Temporal relationship between cocaine use and delusion onset
✓Safety assessment and risk evaluation
✓Treatment plan including antipsychotic considerations

Commonly Confused Codes

•F14.251: Cocaine dependence with cocaine-induced psychotic disorder with hallucinations: use when hallucinations are the primary psychotic symptom
•F14.259: Cocaine dependence with cocaine-induced psychotic disorder, unspecified: use when the type of psychosis is not specified
•F14.150: Cocaine abuse with cocaine-induced psychotic disorder with delusions: use when the pattern is abuse
•F14.222: Cocaine dependence with intoxication with perceptual disturbance: use for transient perceptual changes not meeting psychosis criteria
•F22: Delusional disorders: use only when delusions are primary, not substance-induced