F19.930 ICD-10-CM Code: Other psychoactive substance use, unspecified with withdrawal, uncomplicated
F19.930 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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FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Mental and behavioral disorders due to psychoactive substance use (F10-F19)
F19.930
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceOther psychoactive substance use, unspecified with withdrawal, uncomplicated
Stopping use of various psychoactive substances with withdrawal symptoms that are manageable without severe complications.
Buddy Insight
Other psychoactive substance use, unspecified with withdrawal, uncomplicated indicates a patient experiencing withdrawal symptoms from psychoactive substances without the serious complications of delirium or perceptual disturbances.
CMS-HCC V28
MappedHCC 137
Coefficient HCC 137: 0.424 (Community Non-Dual Aged (CNA))
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
MappedHCC 082
Code-level coefficient reference
ESRD/PACE
MappedHCC 55
Code-level coefficient reference
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for F19.930. 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, F19
- polysubstance drug use (indiscriminate drug use)Inherited from F01-F99, F19
Excludes 1
Official- other psychoactive substance abuse (F19.1-)Inherited from F19.9, F19.93
- other psychoactive substance dependence (F19.2-)Inherited from F19.9, F19.93
- other psychoactive substance use, unspecified with intoxication (F19.92-)Inherited from F19.9, F19.93
Code First
OfficialNo Code First sequencing instructions are included in this display for F19.930. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for F19.930. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for F19.930. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 F19.930 an HCC code?
Yes. F19.930 (Other psychoactive substance use, unspecified with withdrawal, 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: F19.930 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
- F19.930
- Description
- Other psychoactive substance use, unspecified with withdrawal, 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
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 F19.930 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for F19.930
For F19.930, 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
F19.930 is the ICD-10-CM diagnosis code for other psychoactive substance use, unspecified with withdrawal, uncomplicated. Stopping use of various psychoactive substances with withdrawal symptoms that are manageable without severe complications. F19.930 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, F19.930 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 F19.930; use the applicable model and payment year when reviewing the V28 mapping. 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.
Use this code for withdrawal symptoms without delirium or perceptual disturbances. For F19.930, 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 F19.930 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code for withdrawal symptoms without delirium or perceptual disturbances
- •Common withdrawal symptoms include anxiety, tremors, sweating, and insomnia
Clinical Significance
Other psychoactive substance use, unspecified with withdrawal, uncomplicated indicates a patient experiencing withdrawal symptoms from psychoactive substances without the serious complications of delirium or perceptual disturbances. Withdrawal management is a critical clinical scenario requiring monitoring and often pharmacological support. This code is important for risk adjustment because it captures the active treatment burden of substance withdrawal.
Documentation Requirements
- ✓Documentation that the patient is in active withdrawal from a psychoactive substance
- ✓Identification of the specific substance(s) when possible
- ✓Description of withdrawal symptoms present (anxiety, tremors, sweating, insomnia, nausea)
- ✓Clinical assessment confirming absence of delirium or perceptual disturbances
- ✓Use of validated withdrawal assessment tool (CIWA-Ar, COWS) when applicable
- ✓Treatment plan for withdrawal management
Commonly Confused Codes
- •F19.931: Withdrawal WITH DELIRIUM represents a much more severe and dangerous presentation
- •F19.932: Withdrawal WITH PERCEPTUAL DISTURBANCE includes hallucinations during withdrawal
- •F19.230: Substance DEPENDENCE with withdrawal, uncomplicated; use when dependence criteria are documented
- •F19.920: INTOXICATION uncomplicated is the opposite clinical scenario from withdrawal