F15.13
BillableOther stimulant abuse with withdrawal
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F15.13 an HCC code?
Yes. F15.13 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 F15.13
For F15.13 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 F15.13 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F15.13 is the ICD-10-CM diagnosis code for other stimulant abuse with withdrawal. Withdrawal symptoms occurring after stopping or reducing use of stimulant drugs like cocaine or amphetamines. F15.13 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, F15.13 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, F15.13 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 specific withdrawal symptoms (fatigue, depression, anxiety) when present to support medical necessity. Because F15.13 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 F15.13 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document specific withdrawal symptoms (fatigue, depression, anxiety) when present to support medical necessity
- •Distinguish from intoxication codes; withdrawal occurs after cessation or reduction of use
Clinical Significance
Other stimulant abuse with withdrawal captures withdrawal symptoms in a patient abusing non-cocaine stimulants (amphetamines, methamphetamine, prescription stimulants). Stimulant withdrawal presents primarily with psychological symptoms: severe depression, anhedonia, fatigue, hypersomnia, increased appetite, and psychomotor retardation. Methamphetamine withdrawal can be particularly prolonged due to the drug's neurotoxic effects on dopamine neurons. Suicide risk is elevated during the withdrawal phase due to profound dysphoria.
Documentation Requirements
- ✓Provider documentation of stimulant abuse (not dependence)
- ✓Identification of the specific stimulant when possible
- ✓Documentation of recent cessation or reduction of stimulant use
- ✓Specific withdrawal symptoms described (depression, fatigue, anhedonia, hypersomnia, increased appetite, psychomotor changes)
- ✓Timeline of symptom onset relative to last stimulant use
- ✓Suicide risk assessment
- ✓Treatment plan for managing withdrawal