Yes. F19.922 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. F19.922 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for F19.922?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For F19.922, V28 maps to Drug Use Disorder/Substance Use Disorder, Moderate/Severe at RAF 0.358 while V24 mapped to Drug/Alcohol Dependence at RAF 0.334. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting F19.922?

This code specifically indicates perceptual disturbances (hallucinations) during intoxication Document whether hallucinations are visual, auditory, or tactile for clinical clarity Because F19.922 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

F19.922 ICD-10 Code: Other psychoactive substance

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupF19.922Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

F19.922

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

Other psychoactive substance use, unspecified with intoxication with perceptual disturbance

Current use of various psychoactive substances causing intoxication with visual, auditory, or tactile hallucinations or distorted perceptions.

Buddy Insight

Other psychoactive substance use, unspecified with intoxication with perceptual disturbance captures substance intoxication complicated by hallucinations or sensory distortions without full delirium.

CMS-HCC V28

Mapped

HCC 137

Drug Use Disorder/Substance U...

RAF 0.358

CMS-HCC V24

Mapped

HCC 55

Drug/Alcohol Dependence

RAF 0.334

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Mapped

HCC 55

Drug/Alcohol Dependence

RAF 0.0

RXHCC

Not risk-adjusted for this model/period.

RAF 0

Code Trumping

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Compare selected patient codes to show trumped or trumps impact.

Code Book Path

Official

F19.9Other psychoactive substance use, unspecified

F19.92Other psychoactive substance use, unspecified with intoxication

F19.922Other psychoactive substance use, unspecified with intoxication with perceptual disturbance

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for F19.922 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for F19.922 in this effective period.

Related Child Codes

Official

F19.920Other psychoactive substance use, unspecified with intoxication, uncomplicated

F19.921Other psychoactive substance use, unspecified with intoxication with delirium

F19.929Other psychoactive substance use, unspecified with intoxication, unspecified

Includes

Official

ICD-10-CM does not list Includes notes for F19.922 in this effective period.

Excludes 1

Official

other psychoactive substance use, unspecified with withdrawal (F19.93)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for F19.922 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for F19.922 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for F19.922 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documentation of current intoxication from psychoactive substance(s)

Specific description of perceptual disturbances (visual, auditory, or tactile hallucinations; illusions; sensory distortions)

Confirmation that the perceptual disturbances are occurring in the context of intoxication, not withdrawal

Assessment that full delirium criteria are NOT met (otherwise code F19.921)

MEAT Support

HCC Buddy guidance

Documentation of current intoxication from psychoactive substance(s)

Specific description of perceptual disturbances (visual, auditory, or tactile hallucinations; illusions; sensory distortions)

Confirmation that the perceptual disturbances are occurring in the context of intoxication, not withdrawal

Assessment that full delirium criteria are NOT met (otherwise code F19.921)

Audit Caution

HCC Buddy guidance

Coding uncomplicated intoxication when the provider has documented hallucinations or perceptual disturbances

Confusing intoxication with perceptual disturbance (transient, during acute intoxication) with substance-induced psychotic disorder (more persistent, may outlast intoxication)

Using this code for withdrawal-related perceptual disturbances, which should be coded under F19.932

Failing to differentiate between delirium and isolated perceptual disturbances in the documentation review

Common Mistakes

HCC Buddy guidance

F19.921 — Intoxication WITH DELIRIUM represents a more severe state with global cognitive dysfunction, not just perceptual disturbances

F19.920 — Intoxication, UNCOMPLICATED should be used when no perceptual disturbances or delirium are present

F19.950 — Substance-induced PSYCHOTIC DISORDER with delusions is a separate condition from intoxication with perceptual disturbance

F19.951 — Substance-induced psychotic disorder with hallucinations is distinct because it represents a psychotic break, not simple intoxication effects

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is F19.922 an HCC code?

Yes. F19.922 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

V28HCC 137, Drug Use Disorder/Substance Use Disorder, Moderate/Severe

0.358

V24HCC 55, Drug/Alcohol Dependence

0.334

ESRDHCC 55, Drug/Alcohol Dependence

0.000

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 F19.922

For F19.922to 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 F19.922 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

F19.922 is the ICD-10-CM diagnosis code for other psychoactive substance use, unspecified with intoxication with perceptual disturbance. Current use of various psychoactive substances causing intoxication with visual, auditory, or tactile hallucinations or distorted perceptions. F19.922 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, F19.922 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, F19.922 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.

This code specifically indicates perceptual disturbances (hallucinations) during intoxication. Because F19.922 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 F19.922 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•This code specifically indicates perceptual disturbances (hallucinations) during intoxication
•Document whether hallucinations are visual, auditory, or tactile for clinical clarity

Clinical Significance

Other psychoactive substance use, unspecified with intoxication with perceptual disturbance captures substance intoxication complicated by hallucinations or sensory distortions without full delirium. This presentation requires careful clinical monitoring as it may progress to a more severe state. The distinction between perceptual disturbances and delirium is clinically significant and affects treatment planning, making accurate coding essential for reflecting the complexity of care provided.

Documentation Requirements

✓Documentation of current intoxication from psychoactive substance(s)
✓Specific description of perceptual disturbances (visual, auditory, or tactile hallucinations; illusions; sensory distortions)
✓Confirmation that the perceptual disturbances are occurring in the context of intoxication, not withdrawal
✓Assessment that full delirium criteria are NOT met (otherwise code F19.921)
✓Clinical evaluation of the patient's insight into the perceptual disturbances
✓Substance identification when possible and safety assessment

Commonly Confused Codes

•F19.921 — Intoxication WITH DELIRIUM represents a more severe state with global cognitive dysfunction, not just perceptual disturbances
•F19.920 — Intoxication, UNCOMPLICATED should be used when no perceptual disturbances or delirium are present
•F19.950 — Substance-induced PSYCHOTIC DISORDER with delusions is a separate condition from intoxication with perceptual disturbance
•F19.951 — Substance-induced psychotic disorder with hallucinations is distinct because it represents a psychotic break, not simple intoxication effects