F14.99
BillableCocaine use, unspecified with unspecified cocaine-induced disorder
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F14.99 an HCC code?
Yes. F14.99 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 F14.99
For F14.99 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 F14.99 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F14.99 is the ICD-10-CM diagnosis code for cocaine use, unspecified with unspecified cocaine-induced disorder. Cocaine use with some cocaine-induced disorder or problem, but the specific type of disorder is not documented or identified. F14.99 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, F14.99 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, F14.99 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.
This is a catch-all code; try to obtain more specific information about the cocaine-induced condition. Because F14.99 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 F14.99 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a catch-all code; try to obtain more specific information about the cocaine-induced condition
- •Query the provider if possible to determine the specific disorder for more accurate coding
Clinical Significance
Cocaine use, unspecified with unspecified cocaine-induced disorder is the least specific combination code in the entire cocaine series. Both the use pattern and the type of induced disorder are unspecified. This code should only be used as a last resort when documentation confirms a cocaine-induced condition exists but provides insufficient detail to determine the specific disorder or use pattern. It represents the maximum documentation gap in cocaine-related coding.
Documentation Requirements
- ✓Documentation of cocaine use
- ✓Documentation that some type of cocaine-induced disorder is present
- ✓Evidence that further specification cannot be determined from available records
- ✓Clinical context supporting the presence of an induced condition
- ✓Documentation of attempts to obtain more specific information
Commonly Confused Codes
- •F14.90 — Cocaine use, unspecified, uncomplicated: use when NO induced disorders are present
- •F14.988 — Cocaine use, unspecified with other cocaine-induced disorder: use when the disorder is identified but does not fit specific categories
- •F14.94 — Cocaine use, unspecified with cocaine-induced mood disorder: use when a mood disorder is identified
- •F14.980 — Cocaine use, unspecified with cocaine-induced anxiety disorder: use when anxiety is identified
- •F14.19 — Cocaine abuse with unspecified cocaine-induced disorder: use when abuse is established