F14.922
BillableCocaine use, unspecified with intoxication with perceptual disturbance
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F14.922 an HCC code?
Yes. F14.922 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 F14.922
For F14.922to 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 F14.922 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F14.922 is the ICD-10-CM diagnosis code for cocaine use, unspecified with intoxication with perceptual disturbance. A person using cocaine who is experiencing intoxication with perceptual disturbances such as seeing or hearing things that aren't there. F14.922 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, F14.922 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, F14.922 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.
Document the specific perceptual disturbances (visual, auditory, tactile) when possible. Because F14.922 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 F14.922 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the specific perceptual disturbances (visual, auditory, tactile) when possible
- •Ensure disturbances are attributed to cocaine intoxication rather than other psychiatric conditions
Clinical Significance
Cocaine use, unspecified with intoxication with perceptual disturbance captures a patient experiencing sensory misperceptions during cocaine intoxication where the use pattern (abuse vs. dependence) has not been determined. Cocaine-related perceptual disturbances include visual trails, tactile sensations (formication), and auditory misperceptions that do not rise to the level of a full psychotic disorder. This condition requires monitored observation to ensure symptoms do not progress to psychosis or delirium.
Documentation Requirements
- ✓Documentation of cocaine use (use pattern may be unspecified)
- ✓Documentation of active intoxication
- ✓Specific description of perceptual disturbances (type and nature)
- ✓Confirmation that symptoms are transient and related to intoxication
- ✓Assessment distinguishing perceptual disturbance from delirium or psychosis
- ✓Vital signs and monitoring documentation
Commonly Confused Codes
- •F14.122 — Cocaine abuse with intoxication with perceptual disturbance: use when abuse is established
- •F14.222 — Cocaine dependence with intoxication with perceptual disturbance: use when dependence is established
- •F14.920 — Cocaine use, unspecified with intoxication, uncomplicated: use when NO perceptual disturbances are present
- •F14.921 — Cocaine use, unspecified with intoxication delirium: use when delirium is the primary feature
- •F14.951 — Cocaine use, unspecified with cocaine-induced psychotic disorder with hallucinations: use when symptoms meet psychosis criteria