2027 ICD-10-CM Diagnosis Code F12.13Cannabis abuse with withdrawal

ICD-10-CM Codes›F01–F99›F10-F19›F12

ICD-10-CM F12.13
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

F12.13 is a billable ICD-10-CM diagnosis code for cannabis abuse with withdrawal. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 894 through 897. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Cannabis-related disorders.

For Medicare Advantage risk adjustment, F12.13 maps to CMS-HCC Category 137 (Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications) under the V28 model, adding a risk factor of about 0.424 for a community, non-dual, aged beneficiary in payment year 2027.

Code Identity

ICD-10-CM Code
F12.13
Billable Status
Yes — Valid for Submission
Code Describes
Cannabis abuse with withdrawal
Short Description
Cannabis abuse with withdrawal
Same as the full description in the CMS dataset.
Parent Code
F12.1
Cannabis abuse

Code Classification

ChapterF01–F99Mental and behavioural disorders
SectionF10-F19Mental and behavioral disorders due to psychoactive substance use
CategoryF12Cannabis related disorders
This CodeF12.13Cannabis abuse with withdrawal

Medicare Risk Adjustment (HCC)Billing

F12.13 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.

CMS-HCC V28 Category (Payment Model)
HCC 137— Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
Payment HCC · PY 2027 one of 308 ICD-10-CM codes in this category
Risk Adjustment Factor (RAF) Weight
+0.424
community, non-dual, aged · ranges 0.297–0.502 across segments
Hierarchy
Superseded by HCC 135 and HCC 136
a more severe related category takes the payment when both are reported
Prior Model (CMS-HCC V24)
HCC 55
V24 retired V28 pays 100% of MA risk scores since PY 2026
Other CMS Models
PACE (CMS-HCC V22): HCC 55 · ESRD (V21): HCC 55 · ESRD (V24): HCC 55
ESRD V21 weights: 0.048 dialysis, 0.112–0.352 functioning graft · ESRD V24 weights: 0.111 dialysis, 0.172–0.416 functioning graft
Part D (RxHCC)
Not mapped
F12.13 does not risk-adjust in the RxHCC prescription drug model

Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to F12.13: its own notes plus those printed at F12.1, F12, and Chapter 5. A note printed at a category, block or chapter applies to every code under it.

Includes

Further defines, or gives examples of, the content of the category.

From F12 Cannabis related disorders applies to 39 codes
  • marijuana
From Chapter 5 (F01-F99) Mental and behavioural disorders applies to 872 codes
  • disorders of psychological development

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From F12.1 Cannabis abuse applies to 13 codes
  • cannabis dependence (F12.2-)
  • cannabis use, unspecified (F12.9-)

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From Chapter 5 (F01-F99) Mental and behavioural disorders applies to 872 codes
  • symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99)

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name F12.13, its category, or a range that includes it.

Excludes1 2

These codes carry an Excludes1 note naming F12.13: they are not reported together with it, unless the two conditions are unrelated.

  • F12.2 Cannabis dependence
    cannabis abuse (F12.1-) names F12.1-, which includes this code
  • F12.9 Cannabis use, unspecified
    cannabis abuse (F12.1-) names F12.1-, which includes this code

Code Also 1

These codes say F12.13 may also be needed to fully describe the condition. The note gives no sequencing direction.

  • R11.16 Cannabis hyperemesis syndrome
    cannabis abuse (F12.1-) names F12.1-, which includes this code

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR MBD019
Cannabis-related disorders
Default principal diagnosis: inpatient Yes · outpatient Yes

Code History & ChangesHistory

Replacement F12.13 replaces the following previously assigned code(s):

  • F12.988 - Cannabis use, unsp with other cannabis-induced disorder
FY 2021AddedAdded to the ICD-10-CM code setEffective October 1, 2020.
FY 2022–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About F12.13Overview

What is the ICD-10 code for cannabis abuse with withdrawal?

The ICD-10-CM code for cannabis abuse with withdrawal is F12.13 (sometimes written as F1213). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is F12.13 (Cannabis abuse) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report cannabis abuse with withdrawal on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does F12.13 group to?

When cannabis abuse with withdrawal is the principal diagnosis on an inpatient stay, it groups to MS-DRG 894, 897, 895, 896, with relative weights from 0.6272 to 1.6610 depending on complications. Higher weights mean higher Medicare reimbursement.

Can F12.13 be reported with a code from F12.2?

Not as a rule. The Excludes1 note at F12.1, which applies to F12.13, lists "cannabis dependence (F12.2-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).

What HCC is F12.13?

F12.13 (cannabis abuse with withdrawal) maps to CMS-HCC Category 137 (Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications), commonly written as HCC 137, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 55 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. It does not map to any RxHCC in the Part D prescription drug model.

Does F12.13 risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, F12.13 adds a risk adjustment factor of about 0.424 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.297 to 0.502 depending on the payment segment). A more severe related category (HCC 135 and HCC 136) supersedes it when both are reported. See the full factor table on the HCC 137 category page.