F14.950
BillableCocaine use, unspecified with cocaine-induced psychotic disorder with delusions
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F14.950 an HCC code?
Yes. F14.950 maps to Drug/Alcohol Psychosis under the CMS-HCC V28 risk adjustment model (and Drug/Alcohol Psychosis 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 F14.950
For F14.950 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 F14.950 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F14.950 is the ICD-10-CM diagnosis code for cocaine use, unspecified with cocaine-induced psychotic disorder with delusions. A person using cocaine who is experiencing psychosis with delusions (false beliefs) caused by the cocaine use. F14.950 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, F14.950 maps to Drug/Alcohol Psychosis (HCC 135) with a community, non-dual, aged base RAF weight of 0.000. Under the older V24 model, F14.950 mapped to the same category but with a base RAF weight of 0.434 — V28 recalibrated weights across the entire model. 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 that delusions are present and directly related to cocaine use. Because F14.950 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 F14.950 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document that delusions are present and directly related to cocaine use
- •Distinguish from primary psychotic disorders; cocaine-induced psychosis typically resolves with abstinence
Clinical Significance
Cocaine use, unspecified with cocaine-induced psychotic disorder with delusions captures a high-acuity condition where cocaine causes delusions in a patient whose use pattern (abuse vs. dependence) is not specified. Cocaine-induced delusions are frequently paranoid in nature and can drive violent behavior, treatment refusal, and emergency psychiatric intervention. This code maps to the higher-weighted psychosis HCC (54) in V24, making accurate capture important for risk adjustment.
Documentation Requirements
- ✓Documentation of cocaine use
- ✓Clear documentation that the psychotic disorder is cocaine-induced
- ✓Specific description of delusions (paranoid, grandiose, persecutory, etc.)
- ✓Documentation ruling out primary psychotic disorders
- ✓Temporal relationship between cocaine use and delusion onset
- ✓Mental status examination documenting delusional thinking
- ✓Safety assessment regarding delusional content
Commonly Confused Codes
- •F14.150 — Cocaine abuse with cocaine-induced psychotic disorder with delusions: use when abuse is established
- •F14.250 — Cocaine dependence with cocaine-induced psychotic disorder with delusions: use when dependence is established
- •F14.951 — Cocaine use, unspecified with cocaine-induced psychotic disorder with hallucinations: use when hallucinations are the primary symptom
- •F14.959 — Cocaine use, unspecified with cocaine-induced psychotic disorder, unspecified: use when the psychosis type is not specified
- •F22 — Delusional disorders: use for primary delusional disorder, not substance-induced