F19.932
BillableOther psychoactive substance use, unspecified with withdrawal with perceptual disturbance
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F19.932 an HCC code?
Yes. F19.932 maps to Drug/Alcohol Psychosis under the CMS-HCC V28 risk adjustment model (and Drug/Alcohol Psychosis 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 F19.932
For F19.932 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 F19.932 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F19.932 is the ICD-10-CM diagnosis code for other psychoactive substance use, unspecified with withdrawal with perceptual disturbance. Stopping use of various psychoactive substances with withdrawal symptoms including hallucinations or distorted perceptions. F19.932 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, F19.932 maps to Drug/Alcohol Psychosis (HCC 135) with a community, non-dual, aged base RAF weight of 0.000. Under the older V24 model, F19.932 mapped to the same category but with a base RAF weight of 0.434 — V28 recalibrated weights across the entire model. 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 indicates withdrawal with perceptual disturbances such as hallucinations. Because F19.932 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 F19.932 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code indicates withdrawal with perceptual disturbances such as hallucinations
- •Document the type of perceptual disturbance (visual, auditory, tactile) when possible
Clinical Significance
Other psychoactive substance use, unspecified with withdrawal with perceptual disturbance represents withdrawal complicated by hallucinations (visual, auditory, or tactile) without meeting full delirium criteria. This is a serious clinical finding that may herald progression to withdrawal delirium and requires close monitoring. Accurate capture is important because it maps to a higher HCC category than uncomplicated withdrawal, reflecting the greater clinical complexity.
Documentation Requirements
- ✓Documentation of active withdrawal from psychoactive substance(s)
- ✓Description of specific perceptual disturbances (type of hallucinations: visual, auditory, tactile)
- ✓Assessment that full delirium criteria are NOT met (otherwise use F19.931)
- ✓Patient's level of insight into the perceptual disturbances
- ✓Monitoring frequency and escalation plan if symptoms worsen
- ✓Treatment interventions for both withdrawal and perceptual disturbances
Commonly Confused Codes
- •F19.931 — Withdrawal DELIRIUM is more severe with global cognitive dysfunction; F19.932 has isolated perceptual disturbances
- •F19.930 — UNCOMPLICATED withdrawal has no perceptual disturbances
- •F19.922 — INTOXICATION with perceptual disturbance occurs during active substance effects, not withdrawal
- •F10.232 — ALCOHOL withdrawal with perceptual disturbance should be used when the substance is specifically alcohol