2027 ICD-10-CM Diagnosis Code F13.950Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced psychotic disorder with delusions
ICD-10-CM Codes›F01–F99›F10-F19›F13
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Risk Adjusts — HCC 135
- Not Chronic
F13.950 is a billable ICD-10-CM diagnosis code for sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced psychotic disorder with delusions. 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. Coders also document this condition as organic delusional disorder caused by psychoactive substance. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Schizophrenia spectrum and other psychotic disorders and Sedative-related disorders.
For Medicare Advantage risk adjustment, F13.950 maps to CMS-HCC Category 135 (Drug Use with 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
Code Classification
Medicare Risk Adjustment (HCC)Billing
F13.950 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.
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.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Organic delusional disorder caused by psychoactive substance
- Sedative, hypnotic AND/OR anxiolytic-induced psychotic disorder with delusions
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to F13.950: its own notes plus those printed at F13.9 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.
- disorders of psychological development
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
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.
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name F13.950, its category, or a range that includes it.
Excludes1 2
These codes carry an Excludes1 note naming F13.950: they are not reported together with it, unless the two conditions are unrelated.
- F13.1 Sedative, hypnotic or anxiolytic-related abusesedative, hypnotic, or anxiolytic use, unspecified (F13.9-) names F13.9-, which includes this code
- F13.2 Sedative, hypnotic or anxiolytic-related dependencesedative, hypnotic, or anxiolytic use, unspecified (F13.9-) names F13.9-, which includes this code
Excludes2 1
These codes carry an Excludes2 note naming F13.950: its condition is not part of those codes, and both may be reported when the patient has both.
Index to Diseases and InjuriesGuidance
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Prescription Drug Misuse
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Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert F13.950 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About F13.950Overview
Is F13.950 a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced psychotic disorder with delusions on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does F13.950 group to?
When sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced psychotic disorder with delusions 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 F13.950 a CC or MCC?
CMS lists F13.950 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 F13.950 be reported with a code from F13.1?
Not as a rule. The Excludes1 note at F13.9, which applies to F13.950, lists "sedative, hypnotic or anxiolytic-related abuse (F13.1-)". 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 is the ICD-9 equivalent of F13.950?
Under the General Equivalence Mappings, sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced psychotic disorder with delusions converts to ICD-9-CM 292.11 (drug psych disor w delus). The mapping is approximate, so confirm the match fits the documentation.
What HCC is F13.950?
F13.950 (sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced psychotic disorder with delusions) maps to CMS-HCC Category 135 (Drug Use with Psychotic Complications), commonly written as HCC 135, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 54 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 F13.950 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, F13.950 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 1.181 depending on the payment segment). HCC 135 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 135 category page.
