F15.221 maps to CMS-HCC V28 137. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC coding software

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupF15.221

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Mental and behavioral disorders due to psychoactive substance use (F10-F19)

F15.221

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Other stimulant dependence with intoxication delirium

A person dependent on stimulants who is intoxicated and experiencing delirium, which is severe confusion and disorientation caused by the drug.

Buddy Insight

Stimulant dependence with intoxication delirium is a medical emergency indicating severe neuropsychiatric toxicity from stimulant use in a dependent patient.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

Mapped

HCC 137

Drug Use Disorder, Moderate/S...

Coefficient HCC 137: 0.424 (Community Non-Dual Aged (CNA))

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

Mapped

HCC 082

HHS-HCC 082 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 55

Substance Use Disorder/Modera...

Code-level coefficient reference

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

F15.2Other stimulant dependence F15.22Other stimulant dependence with intoxication F15.221Other stimulant dependence with intoxication delirium

Inclusion Terms

Official

No inclusion terms are included in this display for F15.221. Check the code and parent instructions in the Code Book.

Excludes 2

Official

symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99)Inherited from F01-F99, F15
cocaine-related disorders (F14.-)Inherited from F01-F99, F15

Related Codes

Official

F15.220Other stimulant dependence with intoxication, uncomplicated F15.222Other stimulant dependence with intoxication with perceptual disturbance F15.229Other stimulant dependence with intoxication, unspecified

Includes

Official

disorders of psychological developmentInherited from F01-F99, F15
amphetamine-related disordersInherited from F01-F99, F15
caffeineInherited from F01-F99, F15

Excludes 1

Official

other stimulant abuse (F15.1-)Inherited from F15.2, F15.22
other stimulant use, unspecified (F15.9-)Inherited from F15.2, F15.22
other stimulant dependence with withdrawal (F15.23)Inherited from F15.2, F15.22

Code First

Official

No Code First sequencing instructions are included in this display for F15.221. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for F15.221. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for F15.221. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Documented stimulant dependence

Clinical evidence of acute intoxication

Specific documentation of delirium: acute onset confusion, altered consciousness, disorientation, fluctuating mental status

Vital signs and laboratory findings supporting the diagnosis (elevated temperature, tachycardia, elevated CK)

MEAT Support

HCC Buddy guidance

Documented stimulant dependence

Clinical evidence of acute intoxication

Specific documentation of delirium: acute onset confusion, altered consciousness, disorientation, fluctuating mental status

Vital signs and laboratory findings supporting the diagnosis (elevated temperature, tachycardia, elevated CK)

Audit Caution

HCC Buddy guidance

Coding uncomplicated intoxication (F15.220) when delirium criteria are met but not explicitly documented

Confusing agitation alone with delirium — delirium requires documented altered consciousness and cognitive changes

Missing the delirium diagnosis when focusing on medical complications like rhabdomyolysis or hyperthermia

Not documenting the temporal relationship between stimulant use and delirium onset

Common Mistakes

HCC Buddy guidance

F15.220 — Stimulant dependence with uncomplicated intoxication; use when delirium is absent

F15.222 — Stimulant dependence with intoxication with perceptual disturbance; perceptual changes without true delirium

F05 — Delirium due to known physiological condition; use for non-substance-induced delirium

F15.121 — Stimulant abuse with intoxication delirium; requires abuse rather than dependence documentation

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is F15.221 an HCC code?

Yes. F15.221 (Other stimulant dependence with intoxication delirium) maps to HCC 137, Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.424. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: F15.221 is billable and maps to V28 HCC 137, Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: F15.221
Description: Other stimulant dependence with intoxication delirium
HCC (V28): HCC 137 — Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
RAF reference coefficient: 0.424
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 137, Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications

0.424

ESRDHCC 55, Substance Use Disorder/Moderate/Severe/Substance Use with Complications

Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work F15.221 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for F15.221

For F15.221, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

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

Coder workflow notes

Get the V28 mapping + MEAT cheat sheet

One printable reference: check representative V28 mappings and the documentation reminders your note needs. Free, no card.

Free PDF. No card. Unsubscribe anytime.

What This Code Means

F15.221 is the ICD-10-CM diagnosis code for other stimulant dependence with intoxication delirium. A person dependent on stimulants who is intoxicated and experiencing delirium, which is severe confusion and disorientation caused by the drug. F15.221 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, F15.221 maps to Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications (HCC 137) with a source-labeled community, non-dual, aged reference coefficient of 0.424. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

Document presence of delirium symptoms such as confusion, disorientation, or altered consciousness during intoxication. For F15.221, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. 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, source-labeled coefficient references, and MEAT documentation criteria for F15.221 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Document presence of delirium symptoms such as confusion, disorientation, or altered consciousness during intoxication
•This is more severe than uncomplicated intoxication and requires specific clinical documentation

Clinical Significance

Stimulant dependence with intoxication delirium is a medical emergency indicating severe neuropsychiatric toxicity from stimulant use in a dependent patient. Delirium during stimulant intoxication can present with extreme agitation, hyperthermia, rhabdomyolysis, and cardiovascular collapse. This high-acuity presentation requires intensive medical management and carries significant morbidity and mortality risk.

Documentation Requirements

✓Documented stimulant dependence
✓Clinical evidence of acute intoxication
✓Specific documentation of delirium: acute onset confusion, altered consciousness, disorientation, fluctuating mental status
✓Vital signs and laboratory findings supporting the diagnosis (elevated temperature, tachycardia, elevated CK)
✓Level of care required and any emergent interventions performed

Commonly Confused Codes

•F15.220: Stimulant dependence with uncomplicated intoxication; use when delirium is absent
•F15.222: Stimulant dependence with intoxication with perceptual disturbance; perceptual changes without true delirium
•F05: Delirium due to known physiological condition; use for non-substance-induced delirium
•F15.121: Stimulant abuse with intoxication delirium; requires abuse rather than dependence documentation