What is ICD-10 code F15.251?

F15.251 is the ICD-10-CM diagnosis code for Other stimulant dependence with stimulant-induced psychotic disorder with hallucinations. A person dependent on stimulants who has developed psychosis with hallucinations, which are false sensory experiences (seeing, hearing, or feeling things that aren't real) caused by stimulant use. F15.251 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. F15.251 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. F15.251 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. F15.251 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does F15.251 map to under V28?

F15.251 maps to CMS-HCC V28 HCC 135 (Drug Use with Psychotic Complications). The category numbers, labels, and conditions come from the CMS-HCC V28 model file for payment year 2026.

2026 ICD-10-CM F15.251: Other stimulant dependence

F15.251 maps to CMS-HCC V28 135. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC coding software

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Code lookupF15.251

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)

F15.251

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

Other stimulant dependence with stimulant-induced psychotic disorder with hallucinations

A person dependent on stimulants who has developed psychosis with hallucinations, which are false sensory experiences (seeing, hearing, or feeling things that aren't real) caused by stimulant use.

Buddy Insight

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

Mapped

HCC 135

Drug Use with Psychotic Compl...

Code-level coefficient reference

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 081

HHS-HCC 081 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 54

Substance Use with Psychotic ...

Code-level coefficient reference

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

F15.2Other stimulant dependence F15.25Other stimulant dependence with stimulant-induced psychotic disorder F15.251Other stimulant dependence with stimulant-induced psychotic disorder with hallucinations

Inclusion Terms

Official

No inclusion terms are included in this display for F15.251. 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

F15.250Other stimulant dependence with stimulant-induced psychotic disorder with delusions F15.259Other stimulant dependence with stimulant-induced psychotic disorder, 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
other stimulant use, unspecified (F15.9-)Inherited from F15.2

Code First

Official

No Code First sequencing instructions are included in this display for F15.251. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for F15.251. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for F15.251. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Documented stimulant dependence

Hallucinations specifically described with type (auditory, visual, tactile)

Temporal relationship between stimulant use and hallucination onset

Documentation distinguishing substance-induced hallucinations from primary psychotic disorder

MEAT Support

HCC Buddy guidance

Documented stimulant dependence

Hallucinations specifically described with type (auditory, visual, tactile)

Temporal relationship between stimulant use and hallucination onset

Documentation distinguishing substance-induced hallucinations from primary psychotic disorder

Audit Caution

HCC Buddy guidance

Coding perceptual disturbance during intoxication (F15.222) when hallucinations persist beyond acute intoxication

Not differentiating between formication (tactile hallucination common with stimulants) and delusional parasitosis

Failing to document the resolution of hallucinations with abstinence to confirm substance-induced etiology

Assigning unspecified psychosis (F15.259) when hallucinations are clearly documented

Common Mistakes

HCC Buddy guidance

F15.250 — Stimulant dependence with psychotic disorder with delusions; delusions vs. hallucinations as predominant feature

F15.222 — Stimulant dependence with intoxication with perceptual disturbance; transient vs. persistent hallucinatory state

F15.151 — Stimulant abuse with psychotic disorder with hallucinations; requires abuse rather than dependence

F20.9 — Schizophrenia, unspecified; primary psychotic disorder, not substance-induced

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 F15.251 an HCC code?

Yes. F15.251 (Other stimulant dependence with stimulant-induced psychotic disorder with hallucinations) maps to HCC 135, Drug Use with 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: F15.251 is billable and maps to V28 HCC 135, Drug Use with Psychotic Complications. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: F15.251
Description: Other stimulant dependence with stimulant-induced psychotic disorder with hallucinations
HCC (V28): HCC 135 — Drug Use with Psychotic Complications
RAF reference coefficient: 0.424
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 135, Drug Use with Psychotic Complications

0.424

ESRDHCC 54, Substance Use with Psychotic 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 F15.251 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for F15.251

For F15.251, 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

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What This Code Means

F15.251 is the ICD-10-CM diagnosis code for other stimulant dependence with stimulant-induced psychotic disorder with hallucinations. A person dependent on stimulants who has developed psychosis with hallucinations, which are false sensory experiences (seeing, hearing, or feeling things that aren't real) caused by stimulant use. F15.251 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, F15.251 maps to Drug Use with Psychotic Complications (HCC 135) with a source-labeled community, non-dual, aged reference coefficient of 0.424. No V24 mapping is shown for F15.251; use the applicable model and payment year when reviewing the V28 mapping. 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 psychotic symptoms with specific mention of hallucinations (false sensory perceptions). For F15.251, 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 F15.251 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Document psychotic symptoms with specific mention of hallucinations (false sensory perceptions)
•Specify the type of hallucinations (visual, auditory, tactile) when documented for clinical clarity

Clinical Significance

Stimulant dependence with stimulant-induced psychotic disorder with hallucinations represents severe psychiatric pathology where chronic stimulant dependence has produced persistent hallucinatory experiences. Stimulant-induced hallucinations are commonly tactile (formication — sensation of bugs crawling on skin) or auditory, and can be difficult to distinguish from primary psychotic disorders. This diagnosis carries the highest risk adjustment weight in the substance use hierarchy.

Documentation Requirements

✓Documented stimulant dependence
✓Hallucinations specifically described with type (auditory, visual, tactile)
✓Temporal relationship between stimulant use and hallucination onset
✓Documentation distinguishing substance-induced hallucinations from primary psychotic disorder
✓Psychiatric assessment documenting the severity and impact of hallucinations
✓Treatment plan for both psychotic symptoms and dependence

Commonly Confused Codes

•F15.250: Stimulant dependence with psychotic disorder with delusions; delusions vs. hallucinations as predominant feature
•F15.222: Stimulant dependence with intoxication with perceptual disturbance; transient vs. persistent hallucinatory state
•F15.151: Stimulant abuse with psychotic disorder with hallucinations; requires abuse rather than dependence
•F20.9: Schizophrenia, unspecified; primary psychotic disorder, not substance-induced