F19.980
BillableOther psychoactive substance use, unspecified with psychoactive substance-induced anxiety disorder
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F19.980 an HCC code?
Yes. F19.980 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
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 F19.980
For F19.980 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 F19.980 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F19.980 is the ICD-10-CM diagnosis code for other psychoactive substance use, unspecified with psychoactive substance-induced anxiety disorder. Excessive worry, nervousness, or panic that develops directly from the use of various psychoactive substances. F19.980 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, F19.980 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, F19.980 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.
Document whether anxiety occurs during intoxication, withdrawal, or persists after substance use. Because F19.980 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 F19.980 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document whether anxiety occurs during intoxication, withdrawal, or persists after substance use
- •Differentiate from primary anxiety disorders
Clinical Significance
Other psychoactive substance use, unspecified with substance-induced anxiety disorder captures anxiety symptoms that are directly caused by substance use in a patient whose use pattern has not been specified as abuse or dependence. Substance-induced anxiety is common and may present as generalized anxiety, panic attacks, or phobias. This distinction from primary anxiety disorders is crucial for treatment planning and risk adjustment, as it reflects the need for integrated behavioral health approaches.
Documentation Requirements
- ✓Documentation of current psychoactive substance use
- ✓Description of anxiety symptoms (generalized anxiety, panic attacks, phobias, obsessive-compulsive features)
- ✓Temporal relationship between substance use and anxiety onset
- ✓Provider determination that anxiety is substance-induced rather than a primary anxiety disorder
- ✓Assessment of whether anxiety occurs during intoxication, withdrawal, or persists after cessation
- ✓Treatment plan addressing both the substance use and the anxiety disorder
Commonly Confused Codes
- •F19.280 — Substance DEPENDENCE with induced anxiety; use when dependence criteria are documented
- •F19.180 — Substance ABUSE with induced anxiety; use when abuse criteria are documented
- •F41.1 — Generalized anxiety disorder is a primary diagnosis, not substance-induced
- •F41.0 — Panic disorder should be used for primary panic disorder unrelated to substance use
- •F19.94 — Substance-induced MOOD disorder is a different category from anxiety