F15.188
BillableOther stimulant abuse with other stimulant-induced disorder
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F15.188 an HCC code?
Yes. F15.188 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 F15.188
For F15.188 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 F15.188 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F15.188 is the ICD-10-CM diagnosis code for other stimulant abuse with other stimulant-induced disorder. This code describes a situation where someone is abusing stimulant drugs (like cocaine, amphetamines, or similar substances) and has developed other related health problems as a result of that abuse. The 'other' designation means the specific disorder caused by the stimulant use doesn't fit into more common categories like anxiety or sleep problems. F15.188 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, F15.188 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, F15.188 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.
Verify documentation specifies both the abuse of stimulants AND an additional stimulant-induced disorder; if only abuse is documented without a specific induced condition, use F15.18 instead. Because F15.188 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 F15.188 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify documentation specifies both the abuse of stimulants AND an additional stimulant-induced disorder; if only abuse is documented without a specific induced condition, use F15.18 instead
- •Review the medical record to identify what specific disorder was induced (such as psychosis, mood disorder, or sexual dysfunction) as this may require an additional code for the induced condition itself
Clinical Significance
This code captures other stimulant-induced disorders during abuse that do not fit into the specific categories of psychosis, anxiety, sexual dysfunction, or sleep disorder. Examples include stimulant-induced obsessive-compulsive disorder, movement disorders, or neurocognitive changes. Documenting these less common but clinically significant complications ensures complete representation of the patient's condition burden.
Documentation Requirements
- ✓Documented stimulant abuse pattern
- ✓Specific description of the induced disorder that does not fit other F15.18x categories
- ✓Clear causal link between stimulant use and the disorder
- ✓Documentation that the disorder is not a pre-existing condition or primary diagnosis
- ✓Clinical management plan for the induced disorder