F15.122 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 lookupF15.122

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)

F15.122

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

Other stimulant abuse with intoxication with perceptual disturbance

Misuse of stimulant drugs (like cocaine or amphetamines) causing intoxication with hallucinations or other sensory disturbances.

Buddy Insight

Other stimulant abuse with intoxication with perceptual disturbance captures sensory misperceptions occurring during intoxication with non-cocaine stimulants.

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

F15.1Other stimulant abuse F15.12Other stimulant abuse with intoxication F15.122Other stimulant abuse with intoxication with perceptual disturbance

Inclusion Terms

Official

Amphetamine or other stimulant use disorder, mild, with amphetamine or other stimulant intoxication, with perceptual disturbances

Excludes 2

Official

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

Related Codes

Official

F15.120Other stimulant abuse with intoxication, uncomplicated F15.121Other stimulant abuse with intoxication delirium F15.129Other stimulant abuse with intoxication, unspecified

Includes

Official

disorders of psychological developmentInherited from F01-F99, F15
amphetamine-related disordersInherited from F01-F99, F15
caffeineInherited from F01-F99, F15

Excludes 1

Official

other stimulant dependence (F15.2-)Inherited from F15.1
other stimulant use, unspecified (F15.9-)Inherited from F15.1

Code First

Official

No Code First sequencing instructions are included in this display for F15.122. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for F15.122. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for F15.122. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

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

MEAT Support

HCC Buddy guidance

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

Audit Caution

HCC Buddy guidance

Confusing transient perceptual disturbance with a full stimulant-induced psychotic disorder

Using cocaine codes for non-cocaine stimulant intoxication

Not documenting the specific type of perceptual disturbance

Coding abuse when the pattern supports dependence

Common Mistakes

HCC Buddy guidance

F15.120 — Other stimulant abuse with intoxication, uncomplicated: use when NO perceptual disturbances are present

F15.121 — Other stimulant abuse with intoxication delirium: use when delirium is the primary feature

F15.150 — Other stimulant abuse with stimulant-induced psychotic disorder with delusions: use when symptoms meet full psychosis criteria

F14.122 — Cocaine abuse with intoxication with perceptual disturbance: use for cocaine-specific intoxication

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 F15.122 an HCC code?

Yes. F15.122 (Other stimulant abuse with intoxication with perceptual disturbance) 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: F15.122 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: F15.122
Description: Other stimulant abuse with intoxication with perceptual disturbance
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 F15.122 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for F15.122

For F15.122, 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

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, 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.

Document the specific stimulant substance when possible (cocaine, amphetamine, etc.) for more precise coding. For F15.122, 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 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

Commonly Confused Codes

•F15.120: Other stimulant abuse with intoxication, uncomplicated: use when NO perceptual disturbances are present
•F15.121: Other stimulant abuse with intoxication delirium: use when delirium is the primary feature
•F15.150: Other stimulant abuse with stimulant-induced psychotic disorder with delusions: use when symptoms meet full psychosis criteria
•F14.122: Cocaine abuse with intoxication with perceptual disturbance: use for cocaine-specific intoxication
•F15.222: Other stimulant dependence with intoxication with perceptual disturbance: use when the pattern is dependence