F15.122
BillableOther stimulant abuse with intoxication with perceptual disturbance
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F15.122 an HCC code?
Yes. F15.122 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 F15.122
For F15.122 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 F15.122 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F15.122 is the ICD-10-CM diagnosis code for other stimulant abuse with intoxication with perceptual disturbance. Misuse of stimulant drugs (like cocaine or amphetamines) causing intoxication with hallucinations or other sensory disturbances. F15.122 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, F15.122 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, F15.122 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.
Document the specific stimulant substance when possible (cocaine, amphetamine, etc.) for more precise coding. Because F15.122 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 F15.122 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the specific stimulant substance when possible (cocaine, amphetamine, etc.) for more precise coding
- •Verify that perceptual disturbances are present during the intoxication episode to distinguish from other intoxication codes
Clinical Significance
Other stimulant abuse with intoxication with perceptual disturbance captures sensory misperceptions occurring during intoxication with non-cocaine stimulants. Methamphetamine and amphetamine intoxication can produce visual hallucinations, tactile hallucinations (bugs crawling on skin), and paranoid ideation with perceptual components. These symptoms are common in methamphetamine users and represent an intermediate severity between uncomplicated intoxication and full psychotic disorder.
Documentation Requirements
- ✓Provider documentation of stimulant abuse (not dependence)
- ✓Documentation of active intoxication
- ✓Specific description of perceptual disturbances (visual, tactile, auditory)
- ✓Identification of the specific stimulant when possible
- ✓Assessment distinguishing perceptual disturbance from delirium or psychosis
- ✓Documentation that disturbances are transient and related to intoxication
- ✓Vital signs and neurological assessment