F16.180 ICD-10-CM Code: Hallucinogen abuse with hallucinogen-induced anxiety disorder
HCC Buddy Code Card
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FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Mental and behavioral disorders due to psychoactive substance use (F10-F19)
F16.180
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceHallucinogen abuse with hallucinogen-induced anxiety disorder
Misuse of hallucinogenic drugs causing persistent anxiety disorder as a consequence of the drug use.
Buddy Insight
Hallucinogen abuse with hallucinogen-induced anxiety disorder captures anxiety complications directly caused by hallucinogenic drug use.
CMS-HCC V28
MappedHCC 137
RAF 0.358
CMS-HCC V24
MappedHCC 55
RAF 0.334
ACA/HHS
00
RAF 0
ESRD/PACE
MappedHCC 55
RAF 0.0
RXHCC
00
RAF 0
Code Trumping
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Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for F16.180 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for F16.180 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for F16.180 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for F16.180 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for F16.180 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for F16.180 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for F16.180 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is F16.180 an HCC code?
Yes. F16.180 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 F16.180
For F16.180to 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 F16.180 during that encounter, not just copy-forwarded from a problem list.
What This Code Means
F16.180 is the ICD-10-CM diagnosis code for hallucinogen abuse with hallucinogen-induced anxiety disorder. Misuse of hallucinogenic drugs causing persistent anxiety disorder as a consequence of the drug use. F16.180 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, F16.180 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, F16.180 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.
Document that the anxiety disorder is directly related to hallucinogen abuse, not a pre-existing condition. Because F16.180 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 F16.180 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document that the anxiety disorder is directly related to hallucinogen abuse, not a pre-existing condition
- •This represents a longer-term psychiatric consequence rather than acute intoxication effects
Clinical Significance
Hallucinogen abuse with hallucinogen-induced anxiety disorder captures anxiety complications directly caused by hallucinogenic drug use. Hallucinogens can trigger severe anxiety, panic attacks, and phobic responses, particularly in the context of 'bad trips.' Some patients develop persistent anxiety disorders following hallucinogen exposure that require ongoing treatment beyond the acute episode.
Documentation Requirements
- ✓Documented hallucinogen abuse pattern
- ✓Clinical description of anxiety symptoms (panic, generalized anxiety, phobic symptoms)
- ✓Causal relationship between hallucinogen use and anxiety onset documented
- ✓Documentation that anxiety is substance-induced rather than a pre-existing condition
- ✓Treatment plan addressing both the substance abuse and anxiety disorder
Commonly Confused Codes
- •F16.280 — Hallucinogen dependence with anxiety disorder; requires documented dependence
- •F16.980 — Hallucinogen use, unspecified with anxiety disorder; less specific regarding use pattern
- •F41.0 — Panic disorder; primary panic, not substance-induced
- •F41.1 — Generalized anxiety disorder; primary anxiety, not substance-induced
- •F16.120 — Hallucinogen abuse with intoxication, uncomplicated; acute intoxication without anxiety disorder