F14.99 maps to CMS-HCC V28 137. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC coding software

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Code lookupF14.99

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Mental and behavioral disorders due to psychoactive substance use (F10-F19)

F14.99

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

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.

Buddy Insight

Cocaine use, unspecified with unspecified cocaine-induced disorder is the least specific combination code in the entire cocaine series.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

Mapped

HCC 137

Drug Use Disorder, Moderate/S...

Coefficient HCC 137: 0.424 (Community Non-Dual Aged (CNA))

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

Mapped

HCC 082

HHS-HCC 082 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 55

Substance Use Disorder/Modera...

Code-level coefficient reference

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

Inclusion Terms

Official

No inclusion terms are included in this display for F14.99. Check the code and parent instructions in the Code Book.

Excludes 2

Official

symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99)Inherited from F01-F99, F14
other stimulant-related disorders (F15.-)Inherited from F01-F99, F14

Related Codes

Official

F14.90Cocaine use, unspecified, uncomplicated F14.91Cocaine use, unspecified, in remission F14.92Cocaine use, unspecified with intoxication F14.93Cocaine use, unspecified with withdrawal F14.94Cocaine use, unspecified with cocaine-induced mood disorder

Includes

Official

disorders of psychological developmentInherited from F01-F99

Excludes 1

Official

cocaine abuse (F14.1-)Inherited from F14.9
cocaine dependence (F14.2-)Inherited from F14.9

Code First

Official

No Code First sequencing instructions are included in this display for F14.99. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for F14.99. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for F14.99. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

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

MEAT Support

HCC Buddy guidance

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

Audit Caution

HCC Buddy guidance

Defaulting to this maximally unspecified code without attempting provider query for any specificity

Using this code when documentation supports ANY more specific code

Confusing this with F14.90 (uncomplicated use) — an induced disorder must be present

Not documenting that a cocaine-induced disorder exists when using this code

Common Mistakes

HCC Buddy guidance

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

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is F14.99 an HCC code?

Yes. F14.99 (Cocaine use, unspecified with unspecified cocaine-induced disorder) maps to HCC 137, Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.424. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: F14.99 is billable and maps to V28 HCC 137, Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: F14.99
Description: Cocaine use, unspecified with unspecified cocaine-induced disorder
HCC (V28): HCC 137 — Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
RAF reference coefficient: 0.424
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 137, Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications

0.424

ESRDHCC 55, Substance Use Disorder/Moderate/Severe/Substance Use with Complications

Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work F14.99 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for F14.99

For F14.99, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

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

Coder workflow notes

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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, Moderate/Severe, or Drug Use with Non-Psychotic Complications (HCC 137) with a source-labeled community, non-dual, aged reference coefficient of 0.424. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

This is a catch-all code; try to obtain more specific information about the cocaine-induced condition. For F14.99, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. 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, source-labeled coefficient references, 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