F15.959
BillableOther stimulant use, unspecified with stimulant-induced psychotic disorder, unspecified
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F15.959 an HCC code?
Yes. F15.959 maps to Drug/Alcohol Psychosis under the CMS-HCC V28 risk adjustment model (and Drug/Alcohol Psychosis 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 F15.959
For F15.959 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 F15.959 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F15.959 is the ICD-10-CM diagnosis code for other stimulant use, unspecified with stimulant-induced psychotic disorder, unspecified. This code describes a patient who uses stimulant drugs (such as cocaine, amphetamines, or other similar substances) in an unspecified pattern and is experiencing psychotic symptoms (like hallucinations or delusions) caused by the stimulant use, where the specific type of psychotic disorder is not further detailed. F15.959 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, F15.959 maps to Drug/Alcohol Psychosis (HCC 135) with a community, non-dual, aged base RAF weight of 0.000. Under the older V24 model, F15.959 mapped to the same category but with a base RAF weight of 0.434 — V28 recalibrated weights across the entire model. 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.
Use this code only when the documentation confirms stimulant-induced psychosis but does not specify whether it's with delusions, hallucinations, or another psychotic feature; if the specific psychotic manifestation is documented, use a more specific F15.95x code. Because F15.959 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 F15.959 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code only when the documentation confirms stimulant-induced psychosis but does not specify whether it's with delusions, hallucinations, or another psychotic feature; if the specific psychotic manifestation is documented, use a more specific F15.95x code
- •Verify that the psychotic symptoms are directly attributed to stimulant use rather than a primary psychotic disorder; coordinate with clinical documentation to ensure the causality is clearly established
Clinical Significance
Stimulant use, unspecified with unspecified psychotic disorder is the least specific psychosis code in the stimulant use category, with both use pattern and psychotic manifestation left uncharacterized. Despite the double unspecified nature, it still maps to the highest substance use HCC. This code should trigger provider queries on both the use pattern and the specific psychotic features.
Documentation Requirements
- ✓Documentation of stimulant use
- ✓Evidence of psychotic symptoms attributed to stimulant use
- ✓Query to provider to specify delusions vs. hallucinations
- ✓Query to provider to clarify abuse vs. dependence status
- ✓Documentation that psychosis is substance-induced, not primary
Commonly Confused Codes
- •F15.950 — Use when delusions are specifically documented
- •F15.951 — Use when hallucinations are specifically documented
- •F15.150/F15.250 — Use when abuse or dependence status is known along with specific psychotic features
- •F15.99 — Stimulant use, unspecified with unspecified induced disorder; not specific to psychosis