F15.159
BillableOther stimulant abuse with stimulant-induced psychotic disorder, unspecified
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F15.159 an HCC code?
Yes. F15.159 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 F15.159
For F15.159 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 F15.159 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F15.159 is the ICD-10-CM diagnosis code for other stimulant abuse with stimulant-induced psychotic disorder, unspecified. Psychotic symptoms caused by stimulant drug abuse, but the specific type of psychotic symptoms are not detailed. F15.159 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, F15.159 maps to Drug/Alcohol Psychosis (HCC 135) with a community, non-dual, aged base RAF weight of 0.000. Under the older V24 model, F15.159 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.
Use when psychosis is present but hallucinations or delusions are not specifically documented. Because F15.159 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 F15.159 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use when psychosis is present but hallucinations or delusions are not specifically documented
- •Query provider for clarification on psychotic symptoms if documentation is vague
Clinical Significance
This unspecified stimulant-induced psychotic disorder code captures cases where psychosis is documented in the context of stimulant abuse but the specific manifestation (delusions vs. hallucinations) is not detailed. While it still maps to the psychosis HCC, it represents a documentation gap that should prompt a query to the provider. Accurate risk adjustment depends on specificity, and this code signals an opportunity for clinical clarification.
Documentation Requirements
- ✓Documented stimulant abuse pattern
- ✓Clinical evidence of psychotic symptoms attributed to stimulant use
- ✓Documentation that psychosis is substance-induced, not a primary psychiatric condition
- ✓Attempt to specify whether delusions or hallucinations are present (query if not documented)
- ✓Treatment plan addressing both the substance abuse and the psychotic symptoms