F14.280
BillableCocaine dependence with cocaine-induced anxiety disorder
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F14.280 an HCC code?
Yes. F14.280 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).
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 F14.280
For F14.280to 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 F14.280 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F14.280 is the ICD-10-CM diagnosis code for cocaine dependence with cocaine-induced anxiety disorder. A person is dependent on cocaine and also experiences anxiety disorder that is directly caused by their cocaine use. This means their anxiety symptoms are a result of their cocaine addiction rather than a separate anxiety condition. F14.280 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, F14.280 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, F14.280 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.
This code includes both the cocaine dependence and the anxiety disorder in one code—do not code them separately as this would constitute double-counting. Because F14.280 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 F14.280 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code includes both the cocaine dependence and the anxiety disorder in one code—do not code them separately as this would constitute double-counting
- •Ensure documentation clearly establishes the causal relationship between cocaine use and the anxiety symptoms; if anxiety exists independently, a different coding approach may be needed
Clinical Significance
Cocaine dependence with cocaine-induced anxiety disorder reflects a dual condition where chronic cocaine use in a dependent patient has caused persistent anxiety symptoms beyond what is expected during intoxication or withdrawal. Cocaine's effects on norepinephrine and dopamine systems can produce sustained anxiety, panic attacks, and hypervigilance. This combination significantly complicates treatment as anxiety itself can drive continued cocaine use as self-medication, creating a destructive cycle.
Documentation Requirements
- ✓Provider documentation of cocaine dependence
- ✓Clear statement that anxiety disorder is cocaine-induced
- ✓Description of anxiety symptoms (panic attacks, generalized anxiety, social anxiety, phobias)
- ✓Documentation ruling out pre-existing primary anxiety disorders
- ✓Temporal relationship between cocaine use pattern and anxiety onset
- ✓Assessment of whether anxiety drives continued cocaine use
- ✓Integrated treatment plan addressing both conditions
Commonly Confused Codes
- •F14.180 — Cocaine abuse with cocaine-induced anxiety disorder: use when the pattern is abuse, not dependence
- •F14.24 — Cocaine dependence with cocaine-induced mood disorder: use when mood disturbance is the primary induced condition
- •F41.1 — Generalized anxiety disorder: use for primary anxiety not caused by cocaine
- •F14.23 — Cocaine dependence with withdrawal: withdrawal includes anxiety but is coded differently
- •F14.980 — Cocaine use, unspecified with cocaine-induced anxiety disorder: use when abuse vs. dependence is unclear