F16.90 ICD-10-CM Code: Hallucinogen use, unspecified, uncomplicated
F16.90 is not a CMS-HCC payment code. 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)
F16.90
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceHallucinogen use, unspecified, uncomplicated
A person uses hallucinogenic drugs but does not have dependence or any complications from the use.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for F16.90. 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
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 F16.9
- hallucinogen dependence (F16.2-)Inherited from F16.9
Code First
OfficialNo Code First sequencing instructions are included in this display for F16.90. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for F16.90. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for F16.90. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
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 F16.90 an HCC code?
No. F16.90 is a billable ICD-10-CM code with no mapping under the current CMS-HCC V28 community payment model, and none under the ESRD, Part D RxHCC, or HHS-HCC models.
- Code
- F16.90
- Description
- Hallucinogen use, unspecified, uncomplicated
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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What This Code Means
F16.90 is the ICD-10-CM diagnosis code for hallucinogen use, unspecified, uncomplicated. A person uses hallucinogenic drugs but does not have dependence or any complications from the use. F16.90 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).
F16.90 is a billable ICD-10-CM code, but no current CMS-HCC V28 community payment mapping is shown, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.
This code represents non-dependent hallucinogen use without adverse effects or intoxication.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for F16.90 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code represents non-dependent hallucinogen use without adverse effects or intoxication
- •Distinguish from dependence codes (F16.2x) which indicate a pattern of compulsive use