F15.151
BillableOther stimulant abuse with stimulant-induced psychotic disorder with hallucinations
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F15.151 an HCC code?
Yes. F15.151 maps to Drug/Alcohol Psychosis under the CMS-HCC V28 risk adjustment model (and Drug/Alcohol Psychosis 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 F15.151
For F15.151 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 F15.151 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F15.151 is the ICD-10-CM diagnosis code for other stimulant abuse with stimulant-induced psychotic disorder with hallucinations. Hallucinations and other psychotic symptoms directly caused by stimulant drug abuse. F15.151 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, F15.151 maps to Drug/Alcohol Psychosis (HCC 135) with a community, non-dual, aged base RAF weight of 0.000. Under the older V24 model, F15.151 mapped to the same category but with a base RAF weight of 0.434 — V28 recalibrated weights across the entire model. 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 whether hallucinations are visual, auditory, or tactile for complete clinical picture. Because F15.151 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 F15.151 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document whether hallucinations are visual, auditory, or tactile for complete clinical picture
- •Distinguish from primary psychotic disorders by confirming temporal relationship to stimulant use
Clinical Significance
Stimulant-induced psychotic disorder with hallucinations during abuse reflects a severe psychiatric complication where the patient experiences false sensory perceptions directly caused by stimulant use. This condition often presents in emergency settings and may require psychiatric hospitalization for safety and stabilization. Capturing this diagnosis accurately is critical as it carries higher risk adjustment weight than uncomplicated substance abuse.
Documentation Requirements
- ✓Documented pattern of stimulant abuse with the specific stimulant identified when possible
- ✓Clinical description of hallucinations with type specified (auditory, visual, tactile)
- ✓Temporal link between stimulant use and onset of hallucinatory symptoms
- ✓Documentation ruling out primary psychotic disorders as the cause of hallucinations
- ✓Current clinical status and any treatment interventions for the psychotic symptoms
Commonly Confused Codes
- •F15.150 — Stimulant abuse with psychotic disorder with delusions; use F15.151 when hallucinations are the predominant feature
- •F15.122 — Stimulant abuse with intoxication with perceptual disturbance; intoxication-related perceptual changes are transient and less severe than true psychotic hallucinations
- •F15.251 — Stimulant dependence with psychotic disorder with hallucinations; requires documented dependence rather than abuse
- •F14.151 — Cocaine abuse with psychotic disorder with hallucinations; use when cocaine is specifically identified as the stimulant