F14.93
BillableCocaine use, unspecified with withdrawal
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F14.93 an HCC code?
Yes. F14.93 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 F14.93
For F14.93 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 F14.93 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F14.93 is the ICD-10-CM diagnosis code for cocaine use, unspecified with withdrawal. A person using cocaine who is experiencing withdrawal symptoms after stopping or reducing cocaine use. F14.93 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, F14.93 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, F14.93 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.
Document the timeline of cocaine cessation and onset of withdrawal symptoms. Because F14.93 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 F14.93 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the timeline of cocaine cessation and onset of withdrawal symptoms
- •Withdrawal from cocaine typically includes depression, fatigue, and anhedonia rather than physical symptoms
Clinical Significance
Cocaine use, unspecified with withdrawal captures a patient experiencing cocaine withdrawal symptoms where the use pattern (abuse vs. dependence) has not been determined. Cocaine withdrawal predominantly presents with psychological symptoms including severe dysphoria, anhedonia, fatigue, and psychomotor retardation. While not typically medically dangerous like alcohol withdrawal, cocaine withdrawal carries significant suicide risk. The unspecified use pattern represents a documentation gap that should be addressed.
Documentation Requirements
- ✓Documentation of cocaine use (even without specifying abuse or dependence)
- ✓Documentation of recent cessation or reduction in cocaine use
- ✓Specific withdrawal symptoms described (depression, fatigue, vivid dreams, hypersomnia, increased appetite)
- ✓Temporal relationship between cocaine cessation and symptom onset
- ✓Suicide risk assessment
- ✓Treatment plan for managing withdrawal
Commonly Confused Codes
- •F14.13 — Cocaine abuse with withdrawal: use when abuse is established
- •F14.23 — Cocaine dependence with withdrawal: use when dependence is established
- •F14.94 — Cocaine use, unspecified with cocaine-induced mood disorder: use when the mood disturbance extends beyond typical withdrawal
- •F14.920 — Cocaine use, unspecified with intoxication, uncomplicated: opposite clinical scenario (intoxication vs. withdrawal)
- •F14.90 — Cocaine use, unspecified, uncomplicated: use when no intoxication, withdrawal, or induced disorders are present