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F18.280 ICD-10-CM Code: Inhalant dependence with inhalant-induced anxiety disorder

F18.280 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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Code lookupF18.280

FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Mental and behavioral disorders due to psychoactive substance use (F10-F19)

F18.280

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

Inhalant dependence with inhalant-induced anxiety disorder

This code describes a person who is dependent on inhalant substances (like glue, paint thinner, or aerosols) and has developed an anxiety disorder as a direct result of their inhalant use. The anxiety symptoms are caused by and occur alongside the substance dependence.

Buddy the Bee presenting code insight

Buddy Insight

Inhalant dependence with induced anxiety disorder captures anxiety symptoms directly caused by chronic inhalant exposure in a dependent patient.

OverviewRisk ModelsCode BookDocumentationAuditNotesEdition comparison

CMS-HCC V28

HCC 137

Coefficient HCC 137: 0.424 (Community Non-Dual Aged (CNA))

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
F18.2Inhalant dependenceF18.28Inhalant dependence with other inhalant-induced disordersF18.280Inhalant dependence with inhalant-induced anxiety disorder

Inclusion Terms

Official

No inclusion terms are included in this display for F18.280. 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

Official
F18.288Inhalant dependence with other inhalant-induced disorder

Includes

Official
  • disorders of psychological developmentInherited from F01-F99, F18
  • volatile solventsInherited from F01-F99, F18

Excludes 1

Official
  • inhalant abuse (F18.1-)Inherited from F18.2
  • inhalant use, unspecified (F18.9-)Inherited from F18.2

Code First

Official

No Code First sequencing instructions are included in this display for F18.280. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for F18.280. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for F18.280. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance
Documentation of inhalant dependence
Specific anxiety symptoms documented
Provider statement that anxiety is induced by inhalant use
Temporal relationship between inhalant exposure and anxiety onset

MEAT Support

HCC Buddy guidance
Documentation of inhalant dependence
Specific anxiety symptoms documented
Provider statement that anxiety is induced by inhalant use
Temporal relationship between inhalant exposure and anxiety onset

Audit Caution

HCC Buddy guidance
Coding primary anxiety instead of substance-induced anxiety
Confusing withdrawal anxiety with substance-induced anxiety disorder
Not establishing the causal link between inhalant use and anxiety
Missing the induced disorder and coding only uncomplicated dependence

Common Mistakes

HCC Buddy guidance
F18.180 — Inhalant abuse with induced anxiety; use for abuse not dependence
F18.24 — Inhalant dependence with induced mood disorder; mood and anxiety are different
F41.1 — Generalized anxiety disorder; use for primary anxiety
F18.20 — Inhalant dependence, uncomplicated; use when no induced disorders present

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 F18.280 an HCC code?

Yes. F18.280 (Inhalant dependence with inhalant-induced anxiety 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: F18.280 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
F18.280
Description
Inhalant dependence with inhalant-induced anxiety 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

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 F18.280 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for F18.280

For F18.280, 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

F18.280 is the ICD-10-CM diagnosis code for inhalant dependence with inhalant-induced anxiety disorder. This code describes a person who is dependent on inhalant substances (like glue, paint thinner, or aerosols) and has developed an anxiety disorder as a direct result of their inhalant use. The anxiety symptoms are caused by and occur alongside the substance dependence. F18.280 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, F18.280 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. 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.

Verify documentation clearly states both inhalant dependence AND inhalant-induced anxiety disorder to justify this combination code; do not code if anxiety existed before inhalant use began. For F18.280, 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 F18.280 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Verify documentation clearly states both inhalant dependence AND inhalant-induced anxiety disorder to justify this combination code; do not code if anxiety existed before inhalant use began
  • •This code includes the dependence component, so do not separately code F18.20 (inhalant dependence without disorder); the .280 specificity already captures the dependence status

Clinical Significance

Inhalant dependence with induced anxiety disorder captures anxiety symptoms directly caused by chronic inhalant exposure in a dependent patient. Inhalants disrupt GABAergic and glutamatergic neurotransmission, which can produce persistent anxiety that complicates both the dependence treatment and psychiatric management.

Documentation Requirements

  • ✓Documentation of inhalant dependence
  • ✓Specific anxiety symptoms documented
  • ✓Provider statement that anxiety is induced by inhalant use
  • ✓Temporal relationship between inhalant exposure and anxiety onset
  • ✓Differentiation from primary anxiety disorders and withdrawal anxiety
  • ✓Treatment plan addressing both conditions

Commonly Confused Codes

  • •F18.180: Inhalant abuse with induced anxiety; use for abuse not dependence
  • •F18.24: Inhalant dependence with induced mood disorder; mood and anxiety are different
  • •F41.1: Generalized anxiety disorder; use for primary anxiety
  • •F18.20: Inhalant dependence, uncomplicated; use when no induced disorders present

Child Codes

F18.280Inhalant dependence with inhalant-induced anxiety disorder
HCC 137
F18.288Inhalant dependence with other inhalant-induced disorder
HCC 137

Code Hierarchy

└F18Inhalant related disorders└F18.2Inhalant dependence└F18.28Inhalant dependence with other inhalant-induced disorders└F18.280Inhalant dependence with inhalant-induced anxiety disorder
└F18.280Inhalant dependence with inhalant-induced anxiety disorder

Also searched as

  • F18 280
  • F18280

For F18.280, 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.

F18.280 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 F18.280. 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 F18.280 in HCC Buddy

Open F18.280 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.

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