F19.982
BillableOther psychoactive substance use, unspecified with psychoactive substance-induced sleep disorder
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F19.982 an HCC code?
Yes. F19.982 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 F19.982
For F19.982 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 F19.982 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F19.982 is the ICD-10-CM diagnosis code for other psychoactive substance use, unspecified with psychoactive substance-induced sleep disorder. Sleep problems such as insomnia, excessive sleepiness, or abnormal sleep patterns that develop directly from the use of various psychoactive substances. F19.982 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, F19.982 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, F19.982 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.
Specify the type of sleep disturbance (insomnia, hypersomnia, parasomnia) when documented. Because F19.982 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 F19.982 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Specify the type of sleep disturbance (insomnia, hypersomnia, parasomnia) when documented
- •Note whether sleep problems occur during use, withdrawal, or both
Clinical Significance
Other psychoactive substance use, unspecified with substance-induced sleep disorder captures sleep disturbances (insomnia, hypersomnia, parasomnias) directly caused by substance use. Sleep disorders are among the most prevalent comorbidities in substance users and significantly impact treatment outcomes and relapse risk. Accurate coding of this dual condition supports risk adjustment and reflects the integrated care approach needed for these patients.
Documentation Requirements
- ✓Documentation of current psychoactive substance use
- ✓Specific type of sleep disorder identified (insomnia, hypersomnia, parasomnia, circadian rhythm disruption)
- ✓Temporal relationship between substance use and sleep disorder onset
- ✓Provider determination that sleep disturbance is substance-induced
- ✓Assessment of sleep disorder severity and impact on daily functioning
- ✓Whether sleep problems occur during active use, withdrawal, or both
Commonly Confused Codes
- •F19.282 — Substance DEPENDENCE with induced sleep disorder; use when dependence criteria are documented
- •F19.182 — Substance ABUSE with induced sleep disorder; use when abuse criteria are documented
- •G47.00 — Insomnia, unspecified is a primary diagnosis not attributed to substance use
- •F51.01 — Primary insomnia should be used when sleep disorder is unrelated to substance use
- •G47.10 — Hypersomnia, unspecified should be used for primary hypersomnia