F16.24 ICD-10-CM Code: Hallucinogen dependence with hallucinogen-induced mood disorder
F16.24 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 Buddy coding tools
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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)
F16.24
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceHallucinogen dependence with hallucinogen-induced mood disorder
A person dependent on hallucinogenic drugs is experiencing a mood disorder (such as depression or mania) that is caused by the hallucinogen use.
Buddy Insight
Hallucinogen dependence with induced mood disorder captures dual pathology — the dependence itself and a mood disturbance (depression, mania, or mixed) directly caused by hallucinogen use.
CMS-HCC V28
MappedHCC 137
Code-level coefficient reference
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
MappedHCC 082
Code-level coefficient reference
ESRD/PACE
MappedHCC 55
Code-level coefficient reference
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- Other hallucinogen use disorder, moderate, with other hallucinogen induced bipolar or related disorder
- Other hallucinogen use disorder, moderate, with other hallucinogen induced depressive disorder
- Other hallucinogen use disorder, severe, with other hallucinogen-induced bipolar or related disorder
- Other hallucinogen use disorder, severe, with other hallucinogen-induced depressive disorder
- Phencyclidine use disorder, moderate, with phencyclidine induced bipolar or related disorder
- Phencyclidine use disorder, moderate, with phencyclidine induced depressive disorder
- Phencyclidine use disorder, severe, with phencyclidine induced bipolar or related disorder
- Phencyclidine use disorder, severe, with phencyclidine-induced depressive disorder
Excludes 2
Official- symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99)Inherited from F01-F99
Related Codes
Includes
Official- disorders of psychological developmentInherited from F01-F99, F16
- ecstasyInherited from F01-F99, F16
- PCPInherited from F01-F99, F16
- phencyclidineInherited from F01-F99, F16
Excludes 1
Official- hallucinogen abuse (F16.1-)Inherited from F16.2
- hallucinogen use, unspecified (F16.9-)Inherited from F16.2
Code First
OfficialNo Code First sequencing instructions are included in this display for F16.24. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for F16.24. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for F16.24. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 F16.24 an HCC code?
Yes. F16.24 (Hallucinogen dependence with hallucinogen-induced mood disorder) 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: F16.24 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
- F16.24
- Description
- Hallucinogen dependence with hallucinogen-induced mood disorder
- 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
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 F16.24 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for F16.24
For F16.24, 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
F16.24 is the ICD-10-CM diagnosis code for hallucinogen dependence with hallucinogen-induced mood disorder. A person dependent on hallucinogenic drugs is experiencing a mood disorder (such as depression or mania) that is caused by the hallucinogen use. F16.24 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, F16.24 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. No V24 mapping is shown for F16.24; 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.
This code indicates the mood disorder is directly induced by hallucinogen use, not a pre-existing condition. For F16.24, 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 F16.24 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code indicates the mood disorder is directly induced by hallucinogen use, not a pre-existing condition
- •Document the specific type of mood disorder if possible (depressive, manic, or mixed features)
Clinical Significance
Hallucinogen dependence with induced mood disorder captures dual pathology — the dependence itself and a mood disturbance (depression, mania, or mixed) directly caused by hallucinogen use. This combination increases treatment complexity and signals the need for integrated psychiatric and addiction services.
Documentation Requirements
- ✓Documentation of hallucinogen dependence meeting clinical criteria
- ✓Specific mood disorder identified (depressive, manic, or mixed features)
- ✓Provider statement that the mood disorder is induced by the hallucinogen use
- ✓Temporal relationship between hallucinogen use and onset of mood symptoms
- ✓Differentiation from pre-existing mood disorders (major depressive disorder, bipolar disorder)
Commonly Confused Codes
- •F16.14: Hallucinogen abuse with induced mood disorder; use when abuse rather than dependence is documented
- •F16.94: Hallucinogen use, unspecified with induced mood disorder; less specific regarding use pattern
- •F32.9: Major depressive disorder, unspecified; use for primary depression NOT induced by substance use
- •F16.280: Hallucinogen dependence with induced anxiety disorder; anxiety and mood disorders are coded separately