F15.11
BillableOther stimulant abuse, in remission
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F15.11 an HCC code?
Yes. F15.11 maps to Drug Use Disorder/Substance Use Disorder, Mild under the CMS-HCC V28 risk adjustment model (and Drug/Alcohol Abuse, Without 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 F15.11
For F15.11 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 F15.11 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F15.11 is the ICD-10-CM diagnosis code for other stimulant abuse, in remission. A person who previously abused stimulant drugs other than cocaine but is now in recovery or remission from that abuse. F15.11 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, F15.11 maps to Drug Use Disorder/Substance Use Disorder, Mild (HCC 138) with a community, non-dual, aged base RAF weight of 0.476. Under the older CMS-HCC V24 model, F15.11 maps to Drug/Alcohol Abuse, Without Dependence (HCC 56) with a community, non-dual, aged base RAF weight of 0.000. 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.
Use this code when the patient is no longer actively abusing the substance but has a history of abuse. Because F15.11 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 F15.11 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code when the patient is no longer actively abusing the substance but has a history of abuse
- •Document the length of remission if available (early vs sustained remission)
Clinical Significance
Other stimulant abuse, in remission indicates a patient with a history of stimulant abuse (other than cocaine) who is no longer meeting active criteria for the disorder. This code is important for ongoing monitoring because stimulant abuse has high relapse rates, and patients in remission require continued surveillance for relapse triggers, long-term health consequences (cardiovascular disease, dental problems from methamphetamine, cognitive impairment), and psychiatric comorbidities.
Documentation Requirements
- ✓Provider documentation of history of stimulant abuse (not dependence)
- ✓Clear statement that the patient is in remission
- ✓Specification of remission type (early vs. sustained) when available
- ✓Documentation of the specific stimulant previously abused when possible
- ✓Current recovery status and ongoing treatment or support
- ✓Assessment of relapse risk factors
Commonly Confused Codes
- •F15.10 — Other stimulant abuse, uncomplicated: use when the patient still meets active abuse criteria
- •F15.21 — Other stimulant dependence, in remission: use when the prior pattern was dependence, not abuse
- •F14.11 — Cocaine abuse, in remission: use for cocaine-specific abuse in remission
- •Z87.898 — Personal history of other specified risk factors: sometimes incorrectly used instead of remission codes
- •F15.90 — Other stimulant use, unspecified, uncomplicated: use when abuse vs. dependence is unclear