F15.222
BillableOther stimulant dependence with intoxication with perceptual disturbance
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F15.222 an HCC code?
Yes. F15.222 maps to Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications under the CMS-HCC V28 risk adjustment model (and Substance Use Disorder, Moderate/Severe, or Substance Use with Complications 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 F15.222
For F15.222to 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 F15.222 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F15.222 is the ICD-10-CM diagnosis code for other stimulant dependence with intoxication with perceptual disturbance. A person dependent on stimulants who is intoxicated and experiencing perceptual disturbances, such as seeing or hearing things that aren't there. F15.222 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, F15.222 maps to Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications (HCC 137) with a community, non-dual, aged base RAF weight of 0.424. Under the older CMS-HCC V24 model, F15.222 maps to Substance Use Disorder, Moderate/Severe, or Substance Use with Complications (HCC 55) with a community, non-dual, aged base RAF weight of 0.329. 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 specific perceptual disturbances like hallucinations or illusions occurring during intoxication. Because F15.222 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 F15.222 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
Clinical Significance
Stimulant dependence with intoxication with perceptual disturbance captures a clinical scenario where a dependent patient experiences sensory alterations (hallucinations, illusions) during active intoxication. This is distinct from a full psychotic disorder in that perceptual disturbances are transient and directly tied to the acute intoxication episode. Proper differentiation is important for accurate coding and treatment planning.
Documentation Requirements
- ✓Documented stimulant dependence
- ✓Evidence of current stimulant intoxication
- ✓Specific perceptual disturbances documented (visual, auditory, or tactile hallucinations or illusions)
- ✓Documentation that perceptual disturbances are occurring in the context of acute intoxication, not as a persistent psychotic disorder
- ✓Clinical assessment of severity and any safety interventions
Commonly Confused Codes
- •F15.250 — Stimulant dependence with psychotic disorder with delusions; this is a persistent psychotic disorder, not transient intoxication effects
- •F15.251 — Stimulant dependence with psychotic disorder with hallucinations; represents a more persistent psychotic state
- •F15.220 — Stimulant dependence with uncomplicated intoxication; use when no perceptual disturbances are present
- •F15.221 — Stimulant dependence with intoxication delirium; delirium involves broader cognitive impairment beyond perceptual changes