2027 ICD-10-CM Diagnosis Code F14.11Cocaine abuse, in remission

ICD-10-CM Codes›F01–F99›F10-F19›F14

ICD-10-CM F14.11
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

F14.11 is a billable ICD-10-CM diagnosis code for cocaine abuse, in remission. 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. Coders also document this condition as history of cocaine abuse. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Mental and substance use disorders in remission.

For Medicare Advantage risk adjustment, F14.11 maps to CMS-HCC Category 138 (Drug Use Disorder, Mild, Uncomplicated, Except Cannabis) under the V28 model, adding a risk factor of about 0.423 for a community, non-dual, aged beneficiary in payment year 2027.

Code Identity

ICD-10-CM Code
F14.11
Billable Status
Yes — Valid for Submission
Code Describes
Cocaine abuse, in remission
Short Description
Cocaine abuse, in remission
Same as the full description in the CMS dataset.
Parent Code
F14.1
Cocaine abuse

Code Classification

ChapterF01–F99Mental and behavioural disorders
SectionF10-F19Mental and behavioral disorders due to psychoactive substance use
CategoryF14Cocaine related disorders
This CodeF14.11Cocaine abuse, in remission

Medicare Risk Adjustment (HCC)Billing

F14.11 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 138— Drug Use Disorder, Mild, Uncomplicated, Except Cannabis
Payment HCC · PY 2027 one of 14 ICD-10-CM codes in this category
Risk Adjustment Factor (RAF) Weight
+0.423
community, non-dual, aged · ranges 0.264–0.502 across segments
Hierarchy
Superseded by HCC 135, HCC 136, and HCC 137
a more severe related category takes the payment when both are reported
Prior Model (CMS-HCC V24)
HCC 56
V24 retired V28 pays 100% of MA risk scores since PY 2026
Other CMS Models
ESRD (V24): HCC 56
ESRD V24 weights: 0.111 dialysis, 0.169–0.416 functioning graft
Part D (RxHCC)
Not mapped
F14.11 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.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • History of cocaine abuse

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to F14.11: its own notes plus those printed at F14.1, F14, 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

Applicable To

Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.

  • Cocaine use disorder, mild, in early remission
  • Cocaine use disorder, mild, in sustained remission

Excludes1

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

From F14.1 Cocaine abuse applies to 16 codes
  • cocaine dependence (F14.2-)
  • cocaine use, unspecified (F14.9-)

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 F14 Cocaine related disorders applies to 48 codes
  • other stimulant-related disorders (F15.-)
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 F14.11, its category, or a range that includes it.

Excludes1 2

These codes carry an Excludes1 note naming F14.11: they are not reported together with it, unless the two conditions are unrelated.

  • F14.2 Cocaine dependence
    cocaine abuse (F14.1-) names F14.1-, which includes this code
  • F14.9 Cocaine use, unspecified
    cocaine abuse (F14.1-) names F14.1-, which includes this code

Excludes2 1

These codes carry an Excludes2 note naming F14.11: its condition is not part of those codes, and both may be reported when the patient has both.

  • F15 Other stimulant related disorders
    cocaine-related disorders (F14.-) names F14.-, 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 MBD026
Mental and substance use disorders in remission
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Cocaine-Related Disorders

    disorders related or resulting from use of cocaine.

Convert F14.11 to ICD-9-CMHistory

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

ICD-9-CM
305.63 Cocaine abuse-in remiss
Exact Match The mapping is direct, with no qualifiers.

Code History & ChangesHistory

Replacement F14.11 replaces the following previously assigned code(s):

  • F14.10 - Cocaine abuse, uncomplicated
FY 2019AddedAdded to the ICD-10-CM code setEffective October 1, 2018.
FY 2020–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About F14.11Overview

What is the ICD-10 code for cocaine abuse, in remission?

The ICD-10-CM code for cocaine abuse, in remission is F14.11 (sometimes written as F1411). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is F14.11 (Cocaine abuse) a billable code?

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

What MS-DRG does F14.11 group to?

When cocaine abuse, in remission 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 F14.11 be reported with a code from F14.2?

Not as a rule. The Excludes1 note at F14.1, which applies to F14.11, lists "cocaine dependence (F14.2-)". 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 is the ICD-9 equivalent of F14.11?

Under the General Equivalence Mappings, cocaine abuse, in remission converts to ICD-9-CM 305.63 (cocaine abuse-in remiss). The mapping is a direct match.

What HCC is F14.11?

F14.11 (cocaine abuse, in remission) maps to CMS-HCC Category 138 (Drug Use Disorder, Mild, Uncomplicated, Except Cannabis), commonly written as HCC 138, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 56 under the retired V24 model. It also maps in the ESRD (V24) model. It does not map to any RxHCC in the Part D prescription drug model.

Does F14.11 risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, F14.11 adds a risk adjustment factor of about 0.423 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.264 to 0.502 depending on the payment segment). A more severe related category (HCC 135, HCC 136, and HCC 137) supersedes it when both are reported. See the full factor table on the HCC 138 category page.