F19.939 ICD-10-CM Code: Other psychoactive substance use, unspecified with withdrawal, unspecified
F19.939 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)
F19.939
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceOther psychoactive substance use, unspecified with withdrawal, unspecified
Stopping use of various psychoactive substances with withdrawal symptoms, but the specific type or severity is not documented.
Buddy Insight
Other psychoactive substance use, unspecified with withdrawal, unspecified indicates the patient is in substance withdrawal but the specific type or severity of withdrawal symptoms has not been documented.
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 F19.939. 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 F19.939. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for F19.939. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for F19.939. 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 F19.939 an HCC code?
Yes. F19.939 (Other psychoactive substance use, unspecified with withdrawal, unspecified) 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: F19.939 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
- F19.939
- Description
- Other psychoactive substance use, unspecified with withdrawal, unspecified
- 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 F19.939 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for F19.939
For F19.939, 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
F19.939 is the ICD-10-CM diagnosis code for other psychoactive substance use, unspecified with withdrawal, unspecified. Stopping use of various psychoactive substances with withdrawal symptoms, but the specific type or severity is not documented. F19.939 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, F19.939 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.
Use this code only when withdrawal is documented but specific symptoms are not clearly described. For F19.939, 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 F19.939 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code only when withdrawal is documented but specific symptoms are not clearly described
- •Clarify whether delirium or perceptual disturbances are present to assign a more specific code
Clinical Significance
Other psychoactive substance use, unspecified with withdrawal, unspecified indicates the patient is in substance withdrawal but the specific type or severity of withdrawal symptoms has not been documented. Even in its unspecified form, this code still captures an important HCC for risk adjustment.
Documentation Requirements
- ✓Documentation that the patient is in active withdrawal from psychoactive substance(s)
- ✓Attempt to identify the specific substance(s) involved
- ✓Provider query to determine if delirium or perceptual disturbances are present
- ✓Description of withdrawal symptoms observed or reported
- ✓Monitoring and treatment plan documentation
- ✓Assessment of withdrawal severity using validated tools when possible
Commonly Confused Codes
- •F19.930: Use when documentation confirms uncomplicated withdrawal (no delirium or perceptual disturbances)
- •F19.931: Use when withdrawal delirium is documented
- •F19.932: Use when withdrawal with perceptual disturbances is documented
- •F19.29: Dependence with unspecified induced disorder is a different clinical concept from withdrawal