Question 1

What is ICD-10 code F14.91?

Accepted Answer

F14.91 is the ICD-10-CM diagnosis code for cocaine use, unspecified, in remission. A person with a history of cocaine use who is currently in remission and no longer actively using the drug. F14.91 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).

F14.91 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

This code indicates the patient is in recovery; ensure documentation supports remission status.

Question 2

Is F14.91 an HCC code?

Accepted Answer

No. F14.91 is a billable ICD-10-CM code but does not map to any payment HCC category under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can still be reported on Medicare Advantage encounter data submissions, but it does not contribute to the beneficiary's Risk Adjustment Factor (RAF) score and therefore does not affect the risk-adjusted capitation payment to the plan. V28 reached 100% phase-in for payment year 2026.

Question 3

Is F14.91 billable?

Accepted Answer

Yes. F14.91 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. F14.91 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.

Question 4

What is the V28 vs V24 difference for F14.91?

Accepted Answer

F14.91 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither model rewards F14.91 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a payment HCC.

Question 5

What should coders know when reporting F14.91?

Accepted Answer

This code indicates the patient is in recovery; ensure documentation supports remission status Do not use this code if the patient is currently using cocaine or has active symptoms

HCC Buddy Code Card

F14.91

Is F14.91 an HCC code?

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Open F14.91 in the Interactive Encoder

F14.91 ICD-10-CM Code: Cocaine use, unspecified, in remission

HCC Buddy Code Card

F14.91

Is F14.91 an HCC code?

What This Code Means

Coding Tips

Child Codes

Code Hierarchy

Open F14.91 in the Interactive Encoder