F18.180
BillableInhalant abuse with inhalant-induced anxiety disorder
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F18.180 an HCC code?
Yes. F18.180 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 F18.180
For F18.180 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 F18.180 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F18.180 is the ICD-10-CM diagnosis code for inhalant abuse with inhalant-induced anxiety disorder. A person who abuses inhalants (such as glue, paint thinner, or aerosols) and has developed anxiety disorder as a result of this substance use. F18.180 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, F18.180 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, F18.180 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 the specific type of inhalant being abused when possible to support medical necessity. Because F18.180 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 F18.180 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the specific type of inhalant being abused when possible to support medical necessity
- •Ensure anxiety disorder is documented as inhalant-induced rather than a separate primary condition
Clinical Significance
Inhalant abuse with induced anxiety disorder captures anxiety symptoms (panic, generalized anxiety, phobic responses) directly caused by inhalant exposure. Inhalants affect GABA and glutamate neurotransmission, which can produce significant anxiety states requiring integrated addiction and psychiatric treatment.
Documentation Requirements
- ✓Documentation of inhalant abuse
- ✓Specific anxiety symptoms documented
- ✓Provider statement that anxiety is induced by inhalant use
- ✓Temporal relationship between inhalant exposure and anxiety
- ✓Type of inhalant when identifiable
- ✓Differentiation from primary anxiety disorders
Commonly Confused Codes
- •F18.280 — Inhalant dependence with induced anxiety disorder; use when dependence is documented
- •F18.14 — Inhalant abuse with induced mood disorder; mood and anxiety are different categories
- •F41.1 — Generalized anxiety disorder; use for primary anxiety not substance-induced
- •F18.980 — Inhalant use, unspecified with induced anxiety; less specific use pattern