2027 ICD-10-CM Diagnosis Code F13.221Sedative, hypnotic or anxiolytic dependence with intoxication delirium

ICD-10-CM Codes›F01–F99›F10-F19›F13

ICD-10-CM F13.221
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

F13.221 is a billable ICD-10-CM diagnosis code for sedative, hypnotic or anxiolytic dependence with intoxication delirium. 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. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 463 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Sedative-related disorders.

For Medicare Advantage risk adjustment, F13.221 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
F13.221
Billable Status
Yes — Valid for Submission
Code Describes
Sedative, hypnotic or anxiolytic dependence with intoxication delirium
Short Description
Sedatv/hyp/anxiolytc dependence w intoxication delirium
Parent Code
F13.22
Sedative, hypnotic or anxiolytic dependence with intoxication

Code Classification

ChapterF01–F99Mental and behavioural disorders
SectionF10-F19Mental and behavioral disorders due to psychoactive substance use
CategoryF13Sedative, hypnotic, or anxiolytic related disorders
This CodeF13.221Sedative, hypnotic or anxiolytic dependence with intoxication delirium

Medicare Risk Adjustment (HCC)Billing

F13.221 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Superseded by HCC 135 and HCC 136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
F13.221 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 F13.221: its own notes plus those printed at F13.22, F13.2, 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 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 F13.22 Sedative, hypnotic or anxiolytic dependence with intoxication applies to 3 codes
  • sedative, hypnotic or anxiolytic dependence with withdrawal (F13.23-)
From F13.2 Sedative, hypnotic or anxiolytic-related dependence applies to 20 codes
  • sedative, hypnotic or anxiolytic-related abuse (F13.1-)
  • sedative, hypnotic, or anxiolytic use, unspecified (F13.9-)

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 F13.2 Sedative, hypnotic or anxiolytic-related dependence applies to 20 codes
  • sedative, hypnotic, or anxiolytic poisoning (T42.-)
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 F13.221, its category, or a range that includes it.

Excludes1 3

These codes carry an Excludes1 note naming F13.221: they are not reported together with it, unless the two conditions are unrelated.

  • F13.1 Sedative, hypnotic or anxiolytic-related abuse
    sedative, hypnotic or anxiolytic-related dependence (F13.2-) names F13.2-, which includes this code
  • F13.23 Sedative, hypnotic or anxiolytic dependence with withdrawal
    sedative, hypnotic or anxiolytic dependence with intoxication (F13.22-) names F13.22-, which includes this code
  • F13.9 Sedative, hypnotic or anxiolytic-related use, unspecified
    sedative, hypnotic or anxiolytic-related dependence (F13.2-) names F13.2-, which includes this code

Excludes2 1

These codes carry an Excludes2 note naming F13.221: its condition is not part of those codes, and both may be reported when the patient has both.

  • F44.0 Dissociative amnesia
    alcohol-or other psychoactive substance-induced amnestic disorder (F10, F13, F19 with .26, .96) names F13, 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 MBD020
Sedative-related disorders
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Delirium

Delirium is a mental state in which you are confused, disoriented, and not able to think or remember clearly. It usually starts suddenly. It is often temporary and treatable.

The full article covers:

  • What is delirium?
  • What causes delirium?
  • Who is more likely to get delirium?
  • What are the symptoms of delirium?
  • How is delirium diagnosed?
  • What are the treatments for delirium?
  • Can delirium be prevented?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert F13.221 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
292.81 Drug-induced delirium
ApproximateCombination The match is approximate, and more than one code can be needed to describe the source diagnosis. Confirm with contextual judgment.
ICD-9-CM
304.10 Sed,hyp,anxiolyt dep-NOS
ApproximateCombination The match is approximate, and more than one code can be needed to describe the source diagnosis. Confirm with contextual judgment.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About F13.221Overview

What is the ICD-10 code for sedative, hypnotic or anxiolytic dependence with intoxication delirium?

The ICD-10-CM code for sedative, hypnotic or anxiolytic dependence with intoxication delirium is F13.221 (sometimes written as F13221). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is F13.221 a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report sedative, hypnotic or anxiolytic dependence with intoxication delirium on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does F13.221 group to?

When sedative, hypnotic or anxiolytic dependence with intoxication delirium 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.

Is F13.221 a CC or MCC?

CMS lists F13.221 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 463 closely related codes in its exclusion list.

Can F13.221 be reported with a code from F13.23?

Not as a rule. The Excludes1 note at F13.22, which applies to F13.221, lists "sedative, hypnotic or anxiolytic dependence with withdrawal (F13.23-)". 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 F13.221?

F13.221 (sedative, hypnotic or anxiolytic dependence with intoxication delirium) 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 F13.221 risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, F13.221 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.