F15.120
BillableOther stimulant abuse with intoxication, uncomplicated
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F15.120 an HCC code?
Yes. F15.120 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 F15.120
For F15.120 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 F15.120 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F15.120 is the ICD-10-CM diagnosis code for other stimulant abuse with intoxication, uncomplicated. Abuse of stimulant drugs other than cocaine with intoxication symptoms, but without severe complications like delirium. F15.120 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, F15.120 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, F15.120 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.
Intoxication indicates the person is currently under the influence of the stimulant. Because F15.120 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 F15.120 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Intoxication indicates the person is currently under the influence of the stimulant
- •Document vital signs and behavioral changes associated with the intoxication
Clinical Significance
Other stimulant abuse with intoxication, uncomplicated captures an encounter where a patient abusing non-cocaine stimulants (amphetamines, methamphetamine, prescription stimulants) is currently intoxicated without severe complications. Stimulant intoxication presents with euphoria, hyperactivity, agitation, pupil dilation, tachycardia, hypertension, and potentially hyperthermia. This condition requires acute monitoring for cardiovascular events (stroke, myocardial infarction, arrhythmias) and behavioral risk.
Documentation Requirements
- ✓Provider documentation of stimulant abuse (not dependence)
- ✓Identification of the specific stimulant when possible
- ✓Documentation of current intoxication with clinical signs
- ✓Confirmation that no complications (delirium, perceptual disturbance) are present
- ✓Vital signs documented during the intoxication
- ✓Assessment of cardiovascular and behavioral risk
Commonly Confused Codes
- •F15.220 — Other stimulant dependence with intoxication, uncomplicated: use when the pattern is dependence
- •F15.121 — Other stimulant abuse with intoxication delirium: use when delirium is present
- •F15.122 — Other stimulant abuse with intoxication with perceptual disturbance: use when perceptual disturbances are present
- •F14.120 — Cocaine abuse with intoxication, uncomplicated: use for cocaine-specific intoxication
- •F15.129 — Other stimulant abuse with intoxication, unspecified: use when the intoxication type is not specified