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F18.20 ICD-10-CM Code: Inhalant dependence, uncomplicated

F18.20 maps to CMS-HCC V28 137. A source-labeled RAF reference is available. Documentation must support MEAT. MEAT criteria · RAF Calculator · HCC coding software

ICD-10-CM Code View

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)

F18.20

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Inhalant dependence, uncomplicated

A person who is dependent on inhalants (unable to stop using them despite wanting to) without any current complications or other related disorders.

Buddy the Bee presenting code insight

Buddy Insight

Inhalant dependence represents a severe substance use disorder with compulsive use, tolerance, and/or withdrawal despite harmful consequences.

CMS-HCC V28

HCC 137

Code-level coefficient reference

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

HCC 082

Code-level coefficient reference

ESRD/PACE

HCC 55

Code-level coefficient reference

RXHCC

N/A

—

Not mapped

Code Book Path

Official
F18Inhalant related disorders
F18.2Inhalant dependence
F18.20Inhalant dependence, uncomplicated

Inclusion Terms

Official
  • Inhalant use disorder, moderate
  • Inhalant use disorder, severe

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for F18.20 in this effective period.

Related Child Codes

Official
F18.21Inhalant dependence, in remission
F18.22Inhalant dependence with intoxication
F18.24Inhalant dependence with inhalant-induced mood disorder
F18.25Inhalant dependence with inhalant-induced psychotic disorder
F18.27Inhalant dependence with inhalant-induced dementia

Includes

Official

ICD-10-CM does not list Includes notes for F18.20 in this effective period.

Excludes 1

Official
  • inhalant abuse (F18.1-)
  • inhalant use, unspecified (F18.9-)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for F18.20 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for F18.20 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for F18.20 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Provider documentation explicitly using the term 'dependence'
Evidence of dependence criteria: tolerance, withdrawal, compulsive use, inability to cut down
Type of inhalant(s) used when known
Assessment of end-organ damage (neurologic, cardiac, hepatic, renal)

MEAT Support

HCC Buddy guidance
Provider documentation explicitly using the term 'dependence'
Evidence of dependence criteria: tolerance, withdrawal, compulsive use, inability to cut down
Type of inhalant(s) used when known
Assessment of end-organ damage (neurologic, cardiac, hepatic, renal)

Audit Caution

HCC Buddy guidance
Coding abuse when dependence criteria are met — under-codes severity
Using uncomplicated code when induced disorders are present
Not documenting specific dependence criteria that distinguish from abuse
Missing the diagnosis entirely due to patient minimization of inhalant use

Common Mistakes

HCC Buddy guidance
F18.10 — Inhalant abuse, uncomplicated; abuse is less severe than dependence
F18.21 — Inhalant dependence, in remission; use when abstinence has been achieved
F18.220 — Inhalant dependence with intoxication; use when currently intoxicated
F18.90 — Inhalant use, unspecified; does not specify abuse or dependence

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 F18.20 an HCC code?

Yes. F18.20 (Inhalant dependence, uncomplicated) 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: F18.20 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
F18.20
Description
Inhalant dependence, uncomplicated
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

V28HCC 137, Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
0.424
ESRDHCC 55, Substance Use Disorder/Moderate/Severe/Substance Use with Complications
Not separately weighted

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 F18.20 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT Criteria for F18.20

For F18.20 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 F18.20 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

F18.20 is the ICD-10-CM diagnosis code for inhalant dependence, uncomplicated. A person who is dependent on inhalants (unable to stop using them despite wanting to) without any current complications or other related disorders. F18.20 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, F18.20 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 F18.20; use the applicable model and payment year when reviewing the V28 mapping. 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. 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 dependence without intoxication or other specified complications. Because F18.20 maps to an HCC category, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) before the diagnosis is used for risk adjustment. 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 F18.20 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •This code indicates dependence without intoxication or other specified complications
  • •Distinguish between abuse (F18.1x) and dependence (F18.2x) based on loss of control and continued use despite harm

Clinical Significance

Inhalant dependence represents a severe substance use disorder with compulsive use, tolerance, and/or withdrawal despite harmful consequences. Inhalant dependence is particularly dangerous because chronic exposure causes cumulative neurotoxicity, hepatotoxicity, nephrotoxicity, and cardiotoxicity with risk of sudden death.

Documentation Requirements

  • ✓Provider documentation explicitly using the term 'dependence'
  • ✓Evidence of dependence criteria: tolerance, withdrawal, compulsive use, inability to cut down
  • ✓Type of inhalant(s) used when known
  • ✓Assessment of end-organ damage (neurologic, cardiac, hepatic, renal)
  • ✓Statement that dependence is currently uncomplicated (no active intoxication or induced disorders)
  • ✓Treatment plan including rehabilitation and monitoring

Commonly Confused Codes

  • •F18.10: Inhalant abuse, uncomplicated; abuse is less severe than dependence
  • •F18.21: Inhalant dependence, in remission; use when abstinence has been achieved
  • •F18.220: Inhalant dependence with intoxication; use when currently intoxicated
  • •F18.90: Inhalant use, unspecified; does not specify abuse or dependence

Child Codes

F18.20Inhalant dependence, uncomplicated
HCC 137
F18.21Inhalant dependence, in remission
HCC 137
F18.22Inhalant dependence with intoxication
F18.24Inhalant dependence with inhalant-induced mood disorder
HCC 137
F18.25Inhalant dependence with inhalant-induced psychotic disorder
F18.27Inhalant dependence with inhalant-induced dementia
HCC 135
F18.28Inhalant dependence with other inhalant-induced disorders
F18.29Inhalant dependence with unspecified inhalant-induced disorder
HCC 137

Code Hierarchy

└F18Inhalant related disorders└F18.2Inhalant dependence└F18.20Inhalant dependence, uncomplicated
└F18.20Inhalant dependence, uncomplicated

Because F18.20 maps to an HCC category, the documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) before the diagnosis is used for risk adjustment.

F18.20 maps to CMS-HCC V28 category 137, Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. The mapping identifies a payment HCC category for F18.20. Review its source-labeled HCC coefficient above, check the RAF Calculator with complete member context for CMS-HCC V28 PY2026, and confirm the documentation the chart needs before the code is submitted. HCC Buddy shows no RAF score unless every required source and calculation check passes.

Work F18.20 in HCC Buddy

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