F19.980 ICD-10-CM Code: Other psychoactive substance use, unspecified with psychoactive substance-induced anxiety disorder
F19.980 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 · free HCC 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)
F19.980
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceOther 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.
Buddy Insight
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.
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
Official- Other (or unknown) substance-induced anxiety disorder, without use disorder
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
- other psychoactive substance dependence (F19.2-)Inherited from F19.9
Code First
OfficialNo Code First sequencing instructions are included in this display for F19.980. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for F19.980. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for F19.980. 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 F19.980 an HCC code?
Yes. F19.980 (Other psychoactive substance use, unspecified with psychoactive substance-induced anxiety disorder) 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: F19.980 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
- F19.980
- Description
- Other psychoactive substance use, unspecified with psychoactive substance-induced anxiety disorder
- 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 F19.980 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for F19.980
For F19.980, 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
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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, 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.
Document whether anxiety occurs during intoxication, withdrawal, or persists after substance use. For F19.980, 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 F19.980 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