F15.920 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

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Code lookupF15.920

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)

F15.920

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

Other stimulant use, unspecified with intoxication, uncomplicated

A person using stimulant drugs who is currently intoxicated (showing signs of acute drug effects) without severe complications like delirium or hallucinations.

Buddy Insight

Other stimulant use, unspecified with uncomplicated intoxication captures a patient who is currently intoxicated from stimulant use but whose pattern of use (abuse vs.

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

F15.9Other stimulant use, unspecified F15.92Other stimulant use, unspecified with intoxication F15.920Other stimulant use, unspecified with intoxication, uncomplicated

Inclusion Terms

Official

No inclusion terms are included in this display for F15.920. 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

F15.921Other stimulant use, unspecified with intoxication delirium F15.922Other stimulant use, unspecified with intoxication with perceptual disturbance F15.929Other stimulant use, unspecified 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 F15.9, F15.92
other stimulant dependence (F15.2-)Inherited from F15.9, F15.92
other stimulant use, unspecified with withdrawal (F15.93)Inherited from F15.9, F15.92

Code First

Official

No Code First sequencing instructions are included in this display for F15.920. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for F15.920. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for F15.920. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Documentation of stimulant use (specific substance when possible)

Clinical evidence of current intoxication: tachycardia, hypertension, agitation, dilated pupils

Absence of delirium or perceptual disturbances during intoxication

Vital signs and clinical findings supporting the diagnosis

MEAT Support

HCC Buddy guidance

Documentation of stimulant use (specific substance when possible)

Clinical evidence of current intoxication: tachycardia, hypertension, agitation, dilated pupils

Absence of delirium or perceptual disturbances during intoxication

Vital signs and clinical findings supporting the diagnosis

Audit Caution

HCC Buddy guidance

Using this unspecified code when documentation elsewhere in the record indicates abuse or dependence

Not querying the provider to clarify abuse vs. dependence status

Coding uncomplicated intoxication when delirium or perceptual disturbances are present

Not documenting specific intoxication signs to support the code assignment

Common Mistakes

HCC Buddy guidance

F15.120 — Stimulant abuse with intoxication, uncomplicated; use when abuse is documented

F15.220 — Stimulant dependence with intoxication, uncomplicated; use when dependence is documented

F15.921 — Stimulant use, unspecified with intoxication delirium; use when delirium is present

F15.922 — Stimulant use, unspecified with intoxication with perceptual disturbance; use when hallucinations occur

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 F15.920 an HCC code?

Yes. F15.920 (Other stimulant use, unspecified with intoxication, uncomplicated) 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: F15.920 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: F15.920
Description: Other stimulant use, unspecified with intoxication, uncomplicated
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 F15.920 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for F15.920

For F15.920, 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

F15.920 is the ICD-10-CM diagnosis code for other stimulant use, unspecified with intoxication, uncomplicated. A person using stimulant drugs who is currently intoxicated (showing signs of acute drug effects) without severe complications like delirium or hallucinations. F15.920 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, F15.920 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 observable signs of intoxication (elevated heart rate, agitation, dilated pupils) in the clinical record. For F15.920, 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 F15.920 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Document observable signs of intoxication (elevated heart rate, agitation, dilated pupils) in the clinical record
•Distinguish between uncomplicated intoxication and intoxication with delirium or perceptual disturbances

Clinical Significance

Other stimulant use, unspecified with uncomplicated intoxication captures a patient who is currently intoxicated from stimulant use but whose pattern of use (abuse vs. dependence) is not documented. This code is commonly assigned in emergency settings where immediate medical management takes priority over characterizing the substance use pattern. Documentation of the use severity should be pursued for more accurate coding.

Documentation Requirements

✓Documentation of stimulant use (specific substance when possible)
✓Clinical evidence of current intoxication: tachycardia, hypertension, agitation, dilated pupils
✓Absence of delirium or perceptual disturbances during intoxication
✓Vital signs and clinical findings supporting the diagnosis
✓Query to provider regarding abuse vs. dependence status for future encounters

Commonly Confused Codes

•F15.120: Stimulant abuse with intoxication, uncomplicated; use when abuse is documented
•F15.220: Stimulant dependence with intoxication, uncomplicated; use when dependence is documented
•F15.921: Stimulant use, unspecified with intoxication delirium; use when delirium is present
•F15.922: Stimulant use, unspecified with intoxication with perceptual disturbance; use when hallucinations occur