F15.281
BillableOther stimulant dependence 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 F15.281 an HCC code?
Yes. F15.281 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 F15.281
For F15.281 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 F15.281 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F15.281 is the ICD-10-CM diagnosis code for other stimulant dependence with stimulant-induced sexual dysfunction. A person dependent on stimulant drugs who is experiencing sexual dysfunction (such as erectile dysfunction or decreased sexual desire) caused by their stimulant use. F15.281 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, F15.281 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, F15.281 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.
Ensure documentation clearly links the sexual dysfunction to stimulant dependence rather than other medical causes. Because F15.281 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 F15.281 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Ensure documentation clearly links the sexual dysfunction to stimulant dependence rather than other medical causes
- •Consider coding any underlying erectile dysfunction or sexual arousal disorder separately if clinically relevant
Clinical Significance
Stimulant dependence with stimulant-induced sexual dysfunction reflects a significant quality-of-life complication of chronic stimulant use. While stimulants may initially enhance sexual performance, chronic use frequently leads to erectile dysfunction, anorgasmia, decreased libido, and other sexual problems. Documenting this complication captures the full clinical burden of dependence.
Documentation Requirements
- ✓Documented stimulant dependence
- ✓Specific sexual dysfunction described (erectile dysfunction, decreased libido, anorgasmia, delayed ejaculation)
- ✓Causal relationship between chronic stimulant use and sexual dysfunction
- ✓Exclusion of other causes (vascular disease, medications, endocrine disorders)
- ✓Impact on patient functioning and any treatment interventions