F15.181
BillableOther stimulant abuse with stimulant-induced sexual dysfunction
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F15.181 an HCC code?
Yes. F15.181 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 F15.181
For F15.181 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 F15.181 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F15.181 is the ICD-10-CM diagnosis code for other stimulant abuse with stimulant-induced sexual dysfunction. Sexual dysfunction (erectile dysfunction, decreased libido, or other sexual problems) directly caused by stimulant drug abuse. F15.181 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, F15.181 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, F15.181 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 type of sexual dysfunction when possible for clarity. Because F15.181 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 F15.181 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the specific type of sexual dysfunction when possible for clarity
- •Ensure documentation clearly links the sexual dysfunction to stimulant use
Clinical Significance
Stimulant-induced sexual dysfunction during abuse captures an important quality-of-life complication that may not be routinely documented but carries risk adjustment value. Stimulants can cause erectile dysfunction, decreased libido, delayed orgasm, and other sexual problems. Documenting this complication supports comprehensive care planning and accurate severity of illness assessment.
Documentation Requirements
- ✓Documented stimulant abuse pattern
- ✓Specific type of sexual dysfunction identified (erectile dysfunction, decreased libido, anorgasmia)
- ✓Causal relationship documented between stimulant use and sexual dysfunction onset
- ✓Exclusion of other medical causes of sexual dysfunction (vascular, hormonal, medication-related)
- ✓Assessment of impact on patient quality of life and any treatment provided