CMS-HCC Risk Adjustment · V28 Model · Payment Year 2026 308 Codes

HCC 137: Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications ICD-10-CM

CMS-HCC Category 137 (Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 0.297 and 0.502 to a beneficiary's RAF score depending on the payment segment (0.424 for a community, non-dual, aged enrollee). 308 ICD-10-CM diagnosis codes map to HCC 137. A more severe related category (HCC 135 and HCC 136) supersedes it when both are reported.

✓ Built from the official CMS PY 2026 risk adjustment filesV28 pays 100% of MA risk scores from PY 2026
+0.424
RAF, Community Non-Dual Aged
308
ICD-10-CM Codes
HCC 135
Superseded By
PY 2026
Dataset
CMS-HCC V28

RAF Weight by Payment Segment 7 segments

Payment SegmentRelative Factor
Community, non-dual, aged0.424
Community, partial-benefit dual, aged0.394
Community, full-benefit dual, aged0.502
Community, non-dual, disabled0.365
Community, partial-benefit dual, disabled0.348
Community, full-benefit dual, disabled0.471
Institutional0.297

A beneficiary is scored in exactly one segment, set by Medicaid (dual) status, aged or disabled entitlement, and residence. Factors are relative weights, not dollar amounts; new-enrollee segments score on demographics only. In the hierarchy, HCC 135 (Drug Use with Psychotic Complications) and HCC 136 (Alcohol Use with Psychotic Complications) supersede HCC 137 when reported together. HCC 137 in turn supersedes HCC 138 (Drug Use Disorder, Mild, Uncomplicated, Except Cannabis) and HCC 139 (Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications).

ICD-10-CM

ICD-10-CM Codes That Map to HCC 137 308 codes

308 of 308 shown
  • F11.120 Opioid abuse with intoxication, uncomplicated from V24 HCC 55
  • F11.121 Opioid abuse with intoxication delirium from V24 HCC 55
  • F11.122 Opioid abuse with intoxication with perceptual disturbance from V24 HCC 55
  • F11.129 Opioid abuse with intoxication, unspecified from V24 HCC 55
  • F11.13 Opioid abuse with withdrawal from V24 HCC 55
  • F11.14 Opioid abuse with opioid-induced mood disorder from V24 HCC 55
  • F11.181 Opioid abuse with opioid-induced sexual dysfunction from V24 HCC 55
  • F11.182 Opioid abuse with opioid-induced sleep disorder from V24 HCC 55
  • F11.188 Opioid abuse with other opioid-induced disorder from V24 HCC 55
  • F11.19 Opioid abuse with unspecified opioid-induced disorder from V24 HCC 55
  • F11.20 Opioid dependence, uncomplicated from V24 HCC 55
  • F11.21 Opioid dependence, in remission from V24 HCC 55
  • F11.220 Opioid dependence with intoxication, uncomplicated from V24 HCC 55
  • F11.221 Opioid dependence with intoxication delirium from V24 HCC 55
  • F11.222 Opioid dependence with intoxication with perceptual disturbance from V24 HCC 55
  • F11.229 Opioid dependence with intoxication, unspecified from V24 HCC 55
  • F11.23 Opioid dependence with withdrawal from V24 HCC 55
  • F11.24 Opioid dependence with opioid-induced mood disorder from V24 HCC 55
  • F11.281 Opioid dependence with opioid-induced sexual dysfunction from V24 HCC 55
  • F11.282 Opioid dependence with opioid-induced sleep disorder from V24 HCC 55
  • F11.288 Opioid dependence with other opioid-induced disorder from V24 HCC 55
  • F11.29 Opioid dependence with unspecified opioid-induced disorder from V24 HCC 55
  • F11.920 Opioid use, unspecified with intoxication, uncomplicated from V24 HCC 55
  • F11.921 Opioid use, unspecified with intoxication delirium from V24 HCC 55
  • F11.922 Opioid use, unspecified with intoxication with perceptual disturbance from V24 HCC 55
  • F11.929 Opioid use, unspecified with intoxication, unspecified from V24 HCC 55
  • F11.93 Opioid use, unspecified with withdrawal from V24 HCC 55
  • F11.94 Opioid use, unspecified with opioid-induced mood disorder from V24 HCC 55
  • F11.981 Opioid use, unspecified with opioid-induced sexual dysfunction from V24 HCC 55
  • F11.982 Opioid use, unspecified with opioid-induced sleep disorder from V24 HCC 55
  • F11.988 Opioid use, unspecified with other opioid-induced disorder from V24 HCC 55
  • F11.99 Opioid use, unspecified with unspecified opioid-induced disorder from V24 HCC 55
  • F12.13 Cannabis abuse with withdrawal from V24 HCC 55
  • F12.180 Cannabis abuse with cannabis-induced anxiety disorder from V24 HCC 55
  • F12.188 Cannabis abuse with other cannabis-induced disorder from V24 HCC 55
  • F12.20 Cannabis dependence, uncomplicated from V24 HCC 55
  • F12.21 Cannabis dependence, in remission from V24 HCC 55
  • F12.220 Cannabis dependence with intoxication, uncomplicated from V24 HCC 55
  • F12.221 Cannabis dependence with intoxication delirium from V24 HCC 55
  • F12.222 Cannabis dependence with intoxication with perceptual disturbance from V24 HCC 55
  • F12.229 Cannabis dependence with intoxication, unspecified from V24 HCC 55
  • F12.23 Cannabis dependence with withdrawal from V24 HCC 55
  • F12.280 Cannabis dependence with cannabis-induced anxiety disorder from V24 HCC 55
  • F12.288 Cannabis dependence with other cannabis-induced disorder from V24 HCC 55
  • F12.29 Cannabis dependence with unspecified cannabis-induced disorder from V24 HCC 55
  • F12.93 Cannabis use, unspecified with withdrawal from V24 HCC 55
  • F12.980 Cannabis use, unspecified with anxiety disorder from V24 HCC 55
  • F12.988 Cannabis use, unspecified with other cannabis-induced disorder from V24 HCC 55
  • F13.120 Sedative, hypnotic or anxiolytic abuse with intoxication, uncomplicated from V24 HCC 55
  • F13.121 Sedative, hypnotic or anxiolytic abuse with intoxication delirium from V24 HCC 55
  • F13.129 Sedative, hypnotic or anxiolytic abuse with intoxication, unspecified from V24 HCC 55
  • F13.130 Sedative, hypnotic or anxiolytic abuse with withdrawal, uncomplicated from V24 HCC 55
  • F13.139 Sedative, hypnotic or anxiolytic abuse with withdrawal, unspecified from V24 HCC 55
  • F13.14 Sedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced mood disorder from V24 HCC 55
  • F13.180 Sedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced anxiety disorder from V24 HCC 55
  • F13.181 Sedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced sexual dysfunction from V24 HCC 55
  • F13.182 Sedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced sleep disorder from V24 HCC 55
  • F13.188 Sedative, hypnotic or anxiolytic abuse with other sedative, hypnotic or anxiolytic-induced disorder from V24 HCC 55
  • F13.19 Sedative, hypnotic or anxiolytic abuse with unspecified sedative, hypnotic or anxiolytic-induced disorder from V24 HCC 55
  • F13.20 Sedative, hypnotic or anxiolytic dependence, uncomplicated from V24 HCC 55
  • F13.21 Sedative, hypnotic or anxiolytic dependence, in remission from V24 HCC 55
  • F13.220 Sedative, hypnotic or anxiolytic dependence with intoxication, uncomplicated from V24 HCC 55
  • F13.221 Sedative, hypnotic or anxiolytic dependence with intoxication delirium from V24 HCC 55
  • F13.229 Sedative, hypnotic or anxiolytic dependence with intoxication, unspecified from V24 HCC 55
  • F13.230 Sedative, hypnotic or anxiolytic dependence with withdrawal, uncomplicated from V24 HCC 55
  • F13.239 Sedative, hypnotic or anxiolytic dependence with withdrawal, unspecified from V24 HCC 55
  • F13.24 Sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced mood disorder from V24 HCC 55
  • F13.280 Sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced anxiety disorder from V24 HCC 55
  • F13.281 Sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced sexual dysfunction from V24 HCC 55
  • F13.282 Sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced sleep disorder from V24 HCC 55
  • F13.288 Sedative, hypnotic or anxiolytic dependence with other sedative, hypnotic or anxiolytic-induced disorder from V24 HCC 55
  • F13.29 Sedative, hypnotic or anxiolytic dependence with unspecified sedative, hypnotic or anxiolytic-induced disorder from V24 HCC 55
  • F13.920 Sedative, hypnotic or anxiolytic use, unspecified with intoxication, uncomplicated from V24 HCC 55
  • F13.921 Sedative, hypnotic or anxiolytic use, unspecified with intoxication delirium from V24 HCC 55
  • F13.929 Sedative, hypnotic or anxiolytic use, unspecified with intoxication, unspecified from V24 HCC 55
  • F13.930 Sedative, hypnotic or anxiolytic use, unspecified with withdrawal, uncomplicated from V24 HCC 55
  • F13.939 Sedative, hypnotic or anxiolytic use, unspecified with withdrawal, unspecified from V24 HCC 55
  • F13.94 Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced mood disorder from V24 HCC 55
  • F13.980 Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced anxiety disorder from V24 HCC 55
  • F13.981 Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced sexual dysfunction from V24 HCC 55
  • F13.982 Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced sleep disorder from V24 HCC 55
  • F13.988 Sedative, hypnotic or anxiolytic use, unspecified with other sedative, hypnotic or anxiolytic-induced disorder from V24 HCC 55
  • F13.99 Sedative, hypnotic or anxiolytic use, unspecified with unspecified sedative, hypnotic or anxiolytic-induced disorder from V24 HCC 55
  • F14.120 Cocaine abuse with intoxication, uncomplicated from V24 HCC 55
  • F14.121 Cocaine abuse with intoxication with delirium from V24 HCC 55
  • F14.122 Cocaine abuse with intoxication with perceptual disturbance from V24 HCC 55
  • F14.129 Cocaine abuse with intoxication, unspecified from V24 HCC 55
  • F14.13 Cocaine abuse, unspecified with withdrawal from V24 HCC 55
  • F14.14 Cocaine abuse with cocaine-induced mood disorder from V24 HCC 55
  • F14.180 Cocaine abuse with cocaine-induced anxiety disorder from V24 HCC 55
  • F14.181 Cocaine abuse with cocaine-induced sexual dysfunction from V24 HCC 55
  • F14.182 Cocaine abuse with cocaine-induced sleep disorder from V24 HCC 55
  • F14.188 Cocaine abuse with other cocaine-induced disorder from V24 HCC 55
  • F14.19 Cocaine abuse with unspecified cocaine-induced disorder from V24 HCC 55
  • F14.20 Cocaine dependence, uncomplicated from V24 HCC 55
  • F14.21 Cocaine dependence, in remission from V24 HCC 55
  • F14.220 Cocaine dependence with intoxication, uncomplicated from V24 HCC 55
  • F14.221 Cocaine dependence with intoxication delirium from V24 HCC 55
  • F14.222 Cocaine dependence with intoxication with perceptual disturbance from V24 HCC 55
  • F14.229 Cocaine dependence with intoxication, unspecified from V24 HCC 55
  • F14.23 Cocaine dependence with withdrawal from V24 HCC 55
  • F14.24 Cocaine dependence with cocaine-induced mood disorder from V24 HCC 55
  • F14.280 Cocaine dependence with cocaine-induced anxiety disorder from V24 HCC 55
  • F14.281 Cocaine dependence with cocaine-induced sexual dysfunction from V24 HCC 55
  • F14.282 Cocaine dependence with cocaine-induced sleep disorder from V24 HCC 55
  • F14.288 Cocaine dependence with other cocaine-induced disorder from V24 HCC 55
  • F14.29 Cocaine dependence with unspecified cocaine-induced disorder from V24 HCC 55
  • F14.920 Cocaine use, unspecified with intoxication, uncomplicated from V24 HCC 55
  • F14.921 Cocaine use, unspecified with intoxication delirium from V24 HCC 55
  • F14.922 Cocaine use, unspecified with intoxication with perceptual disturbance from V24 HCC 55
  • F14.929 Cocaine use, unspecified with intoxication, unspecified from V24 HCC 55
  • F14.93 Cocaine use, unspecified with withdrawal from V24 HCC 55
  • F14.94 Cocaine use, unspecified with cocaine-induced mood disorder from V24 HCC 55
  • F14.980 Cocaine use, unspecified with cocaine-induced anxiety disorder from V24 HCC 55
  • F14.981 Cocaine use, unspecified with cocaine-induced sexual dysfunction from V24 HCC 55
  • F14.982 Cocaine use, unspecified with cocaine-induced sleep disorder from V24 HCC 55
  • F14.988 Cocaine use, unspecified with other cocaine-induced disorder from V24 HCC 55
  • F14.99 Cocaine use, unspecified with unspecified cocaine-induced disorder from V24 HCC 55
  • F15.120 Other stimulant abuse with intoxication, uncomplicated from V24 HCC 55
  • F15.121 Other stimulant abuse with intoxication delirium from V24 HCC 55
  • F15.122 Other stimulant abuse with intoxication with perceptual disturbance from V24 HCC 55
  • F15.129 Other stimulant abuse with intoxication, unspecified from V24 HCC 55
  • F15.13 Other stimulant abuse with withdrawal from V24 HCC 55
  • F15.14 Other stimulant abuse with stimulant-induced mood disorder from V24 HCC 55
  • F15.180 Other stimulant abuse with stimulant-induced anxiety disorder from V24 HCC 55
  • F15.181 Other stimulant abuse with stimulant-induced sexual dysfunction from V24 HCC 55
  • F15.182 Other stimulant abuse with stimulant-induced sleep disorder from V24 HCC 55
  • F15.188 Other stimulant abuse with other stimulant-induced disorder from V24 HCC 55
  • F15.19 Other stimulant abuse with unspecified stimulant-induced disorder from V24 HCC 55
  • F15.20 Other stimulant dependence, uncomplicated from V24 HCC 55
  • F15.21 Other stimulant dependence, in remission from V24 HCC 55
  • F15.220 Other stimulant dependence with intoxication, uncomplicated from V24 HCC 55
  • F15.221 Other stimulant dependence with intoxication delirium from V24 HCC 55
  • F15.222 Other stimulant dependence with intoxication with perceptual disturbance from V24 HCC 55
  • F15.229 Other stimulant dependence with intoxication, unspecified from V24 HCC 55
  • F15.23 Other stimulant dependence with withdrawal from V24 HCC 55
  • F15.24 Other stimulant dependence with stimulant-induced mood disorder from V24 HCC 55
  • F15.280 Other stimulant dependence with stimulant-induced anxiety disorder from V24 HCC 55
  • F15.281 Other stimulant dependence with stimulant-induced sexual dysfunction from V24 HCC 55
  • F15.282 Other stimulant dependence with stimulant-induced sleep disorder from V24 HCC 55
  • F15.288 Other stimulant dependence with other stimulant-induced disorder from V24 HCC 55
  • F15.29 Other stimulant dependence with unspecified stimulant-induced disorder from V24 HCC 55
  • F15.920 Other stimulant use, unspecified with intoxication, uncomplicated from V24 HCC 55
  • F15.921 Other stimulant use, unspecified with intoxication delirium from V24 HCC 55
  • F15.922 Other stimulant use, unspecified with intoxication with perceptual disturbance from V24 HCC 55
  • F15.929 Other stimulant use, unspecified with intoxication, unspecified from V24 HCC 55
  • F15.93 Other stimulant use, unspecified with withdrawal from V24 HCC 55
  • F15.94 Other stimulant use, unspecified with stimulant-induced mood disorder from V24 HCC 55
  • F15.980 Other stimulant use, unspecified with stimulant-induced anxiety disorder from V24 HCC 55
  • F15.981 Other stimulant use, unspecified with stimulant-induced sexual dysfunction from V24 HCC 55
  • F15.982 Other stimulant use, unspecified with stimulant-induced sleep disorder from V24 HCC 55
  • F15.988 Other stimulant use, unspecified with other stimulant-induced disorder from V24 HCC 55
  • F15.99 Other stimulant use, unspecified with unspecified stimulant-induced disorder from V24 HCC 55
  • F16.120 Hallucinogen abuse with intoxication, uncomplicated from V24 HCC 55
  • F16.121 Hallucinogen abuse with intoxication with delirium from V24 HCC 55
  • F16.122 Hallucinogen abuse with intoxication with perceptual disturbance from V24 HCC 55
  • F16.129 Hallucinogen abuse with intoxication, unspecified from V24 HCC 55
  • F16.14 Hallucinogen abuse with hallucinogen-induced mood disorder from V24 HCC 55
  • F16.180 Hallucinogen abuse with hallucinogen-induced anxiety disorder from V24 HCC 55
  • F16.183 Hallucinogen abuse with hallucinogen persisting perception disorder (flashbacks) from V24 HCC 55
  • F16.188 Hallucinogen abuse with other hallucinogen-induced disorder from V24 HCC 55
  • F16.19 Hallucinogen abuse with unspecified hallucinogen-induced disorder from V24 HCC 55
  • F16.20 Hallucinogen dependence, uncomplicated from V24 HCC 55
  • F16.21 Hallucinogen dependence, in remission from V24 HCC 55
  • F16.220 Hallucinogen dependence with intoxication, uncomplicated from V24 HCC 55
  • F16.221 Hallucinogen dependence with intoxication with delirium from V24 HCC 55
  • F16.229 Hallucinogen dependence with intoxication, unspecified from V24 HCC 55
  • F16.24 Hallucinogen dependence with hallucinogen-induced mood disorder from V24 HCC 55
  • F16.280 Hallucinogen dependence with hallucinogen-induced anxiety disorder from V24 HCC 55
  • F16.283 Hallucinogen dependence with hallucinogen persisting perception disorder (flashbacks) from V24 HCC 55
  • F16.288 Hallucinogen dependence with other hallucinogen-induced disorder from V24 HCC 55
  • F16.29 Hallucinogen dependence with unspecified hallucinogen-induced disorder from V24 HCC 55
  • F16.920 Hallucinogen use, unspecified with intoxication, uncomplicated from V24 HCC 55
  • F16.921 Hallucinogen use, unspecified with intoxication with delirium from V24 HCC 55
  • F16.929 Hallucinogen use, unspecified with intoxication, unspecified from V24 HCC 55
  • F16.94 Hallucinogen use, unspecified with hallucinogen-induced mood disorder from V24 HCC 55
  • F16.980 Hallucinogen use, unspecified with hallucinogen-induced anxiety disorder from V24 HCC 55
  • F16.983 Hallucinogen use, unspecified with hallucinogen persisting perception disorder (flashbacks) from V24 HCC 55
  • F16.988 Hallucinogen use, unspecified with other hallucinogen-induced disorder from V24 HCC 55
  • F16.99 Hallucinogen use, unspecified with unspecified hallucinogen-induced disorder from V24 HCC 55
  • F18.120 Inhalant abuse with intoxication, uncomplicated from V24 HCC 55
  • F18.121 Inhalant abuse with intoxication delirium from V24 HCC 55
  • F18.129 Inhalant abuse with intoxication, unspecified from V24 HCC 55
  • F18.14 Inhalant abuse with inhalant-induced mood disorder from V24 HCC 55
  • F18.180 Inhalant abuse with inhalant-induced anxiety disorder from V24 HCC 55
  • F18.188 Inhalant abuse with other inhalant-induced disorder from V24 HCC 55
  • F18.19 Inhalant abuse with unspecified inhalant-induced disorder from V24 HCC 55
  • F18.20 Inhalant dependence, uncomplicated from V24 HCC 55
  • F18.21 Inhalant dependence, in remission from V24 HCC 55
  • F18.220 Inhalant dependence with intoxication, uncomplicated from V24 HCC 55
  • F18.221 Inhalant dependence with intoxication delirium from V24 HCC 55
  • F18.229 Inhalant dependence with intoxication, unspecified from V24 HCC 55
  • F18.24 Inhalant dependence with inhalant-induced mood disorder from V24 HCC 55
  • F18.280 Inhalant dependence with inhalant-induced anxiety disorder from V24 HCC 55
  • F18.288 Inhalant dependence with other inhalant-induced disorder from V24 HCC 55
  • F18.29 Inhalant dependence with unspecified inhalant-induced disorder from V24 HCC 55
  • F18.920 Inhalant use, unspecified with intoxication, uncomplicated from V24 HCC 55
  • F18.921 Inhalant use, unspecified with intoxication with delirium from V24 HCC 55
  • F18.929 Inhalant use, unspecified with intoxication, unspecified from V24 HCC 55
  • F18.94 Inhalant use, unspecified with inhalant-induced mood disorder from V24 HCC 55
  • F18.980 Inhalant use, unspecified with inhalant-induced anxiety disorder from V24 HCC 55
  • F18.988 Inhalant use, unspecified with other inhalant-induced disorder from V24 HCC 55
  • F18.99 Inhalant use, unspecified with unspecified inhalant-induced disorder from V24 HCC 55
  • F19.120 Other psychoactive substance abuse with intoxication, uncomplicated from V24 HCC 55
  • F19.121 Other psychoactive substance abuse with intoxication delirium from V24 HCC 55
  • F19.122 Other psychoactive substance abuse with intoxication with perceptual disturbances from V24 HCC 55
  • F19.129 Other psychoactive substance abuse with intoxication, unspecified from V24 HCC 55
  • F19.130 Other psychoactive substance abuse with withdrawal, uncomplicated from V24 HCC 55
  • F19.139 Other psychoactive substance abuse with withdrawal, unspecified from V24 HCC 55
  • F19.14 Other psychoactive substance abuse with psychoactive substance-induced mood disorder from V24 HCC 55
  • F19.180 Other psychoactive substance abuse with psychoactive substance-induced anxiety disorder from V24 HCC 55
  • F19.181 Other psychoactive substance abuse with psychoactive substance-induced sexual dysfunction from V24 HCC 55
  • F19.182 Other psychoactive substance abuse with psychoactive substance-induced sleep disorder from V24 HCC 55
  • F19.188 Other psychoactive substance abuse with other psychoactive substance-induced disorder from V24 HCC 55
  • F19.19 Other psychoactive substance abuse with unspecified psychoactive substance-induced disorder from V24 HCC 55
  • F19.20 Other psychoactive substance dependence, uncomplicated from V24 HCC 55
  • F19.21 Other psychoactive substance dependence, in remission from V24 HCC 55
  • F19.220 Other psychoactive substance dependence with intoxication, uncomplicated from V24 HCC 55
  • F19.221 Other psychoactive substance dependence with intoxication delirium from V24 HCC 55
  • F19.222 Other psychoactive substance dependence with intoxication with perceptual disturbance from V24 HCC 55
  • F19.229 Other psychoactive substance dependence with intoxication, unspecified from V24 HCC 55
  • F19.230 Other psychoactive substance dependence with withdrawal, uncomplicated from V24 HCC 55
  • F19.239 Other psychoactive substance dependence with withdrawal, unspecified from V24 HCC 55
  • F19.24 Other psychoactive substance dependence with psychoactive substance-induced mood disorder from V24 HCC 55
  • F19.280 Other psychoactive substance dependence with psychoactive substance-induced anxiety disorder from V24 HCC 55
  • F19.281 Other psychoactive substance dependence with psychoactive substance-induced sexual dysfunction from V24 HCC 55
  • F19.282 Other psychoactive substance dependence with psychoactive substance-induced sleep disorder from V24 HCC 55
  • F19.288 Other psychoactive substance dependence with other psychoactive substance-induced disorder from V24 HCC 55
  • F19.29 Other psychoactive substance dependence with unspecified psychoactive substance-induced disorder from V24 HCC 55
  • F19.920 Other psychoactive substance use, unspecified with intoxication, uncomplicated from V24 HCC 55
  • F19.921 Other psychoactive substance use, unspecified with intoxication with delirium from V24 HCC 55
  • F19.922 Other psychoactive substance use, unspecified with intoxication with perceptual disturbance from V24 HCC 55
  • F19.929 Other psychoactive substance use, unspecified with intoxication, unspecified from V24 HCC 55
  • F19.930 Other psychoactive substance use, unspecified with withdrawal, uncomplicated from V24 HCC 55
  • F19.939 Other psychoactive substance use, unspecified with withdrawal, unspecified from V24 HCC 55
  • F19.94 Other psychoactive substance use, unspecified with psychoactive substance-induced mood disorder from V24 HCC 55
  • F19.980 Other psychoactive substance use, unspecified with psychoactive substance-induced anxiety disorder from V24 HCC 55
  • F19.981 Other psychoactive substance use, unspecified with psychoactive substance-induced sexual dysfunction from V24 HCC 55
  • F19.982 Other psychoactive substance use, unspecified with psychoactive substance-induced sleep disorder from V24 HCC 55
  • F19.988 Other psychoactive substance use, unspecified with other psychoactive substance-induced disorder from V24 HCC 55
  • F19.99 Other psychoactive substance use, unspecified with unspecified psychoactive substance-induced disorder from V24 HCC 55
  • P04.0 Newborn affected by maternal anesthesia and analgesia in pregnancy, labor and delivery new to V28
  • P04.11 Newborn affected by maternal antineoplastic chemotherapy new to V28
  • P04.12 Newborn affected by maternal cytotoxic drugs new to V28
  • P04.13 Newborn affected by maternal use of anticonvulsants new to V28
  • P04.14 Newborn affected by maternal use of opiates new to V28
  • P04.15 Newborn affected by maternal use of antidepressants new to V28
  • P04.16 Newborn affected by maternal use of amphetamines new to V28
  • P04.17 Newborn affected by maternal use of sedative-hypnotics new to V28
  • P04.18 Newborn affected by other maternal medication new to V28
  • P04.19 Newborn affected by maternal use of unspecified medication new to V28
  • P04.1A Newborn affected by maternal use of anxiolytics new to V28
  • P04.2 Newborn affected by maternal use of tobacco new to V28
  • P04.3 Newborn affected by maternal use of alcohol new to V28
  • P04.40 Newborn affected by maternal use of unspecified drugs of addiction new to V28
  • P04.41 Newborn affected by maternal use of cocaine new to V28
  • P04.42 Newborn affected by maternal use of hallucinogens new to V28
  • P04.49 Newborn affected by maternal use of other drugs of addiction new to V28
  • P04.5 Newborn affected by maternal use of nutritional chemical substances new to V28
  • P04.6 Newborn affected by maternal exposure to environmental chemical substances new to V28
  • P04.81 Newborn affected by maternal use of cannabis new to V28
  • P04.89 Newborn affected by other maternal noxious substances new to V28
  • P04.9 Newborn affected by maternal noxious substance, unspecified new to V28
  • P93.0 Grey baby syndrome new to V28
  • P93.8 Other reactions and intoxications due to drugs administered to newborn new to V28
  • P96.1 Neonatal withdrawal symptoms from maternal use of drugs of addiction new to V28
  • P96.2 Withdrawal symptoms from therapeutic use of drugs in newborn new to V28
  • R11.16 Cannabis hyperemesis syndrome new to V28
  • T40.0X1A Poisoning by opium, accidental (unintentional), initial encounter from V24 HCC 55
  • T40.0X4A Poisoning by opium, undetermined, initial encounter from V24 HCC 55
  • T40.1X1A Poisoning by heroin, accidental (unintentional), initial encounter from V24 HCC 55
  • T40.1X4A Poisoning by heroin, undetermined, initial encounter from V24 HCC 55
  • T40.2X1A Poisoning by other opioids, accidental (unintentional), initial encounter from V24 HCC 55
  • T40.2X4A Poisoning by other opioids, undetermined, initial encounter from V24 HCC 55
  • T40.3X1A Poisoning by methadone, accidental (unintentional), initial encounter from V24 HCC 55
  • T40.3X4A Poisoning by methadone, undetermined, initial encounter from V24 HCC 55
  • T40.411A Poisoning by fentanyl or fentanyl analogs, accidental (unintentional), initial encounter from V24 HCC 55
  • T40.414A Poisoning by fentanyl or fentanyl analogs, undetermined, initial encounter from V24 HCC 55
  • T40.421A Poisoning by tramadol, accidental (unintentional), initial encounter from V24 HCC 55
  • T40.424A Poisoning by tramadol, undetermined, initial encounter from V24 HCC 55
  • T40.491A Poisoning by other synthetic narcotics, accidental (unintentional), initial encounter from V24 HCC 55
  • T40.494A Poisoning by other synthetic narcotics, undetermined, initial encounter from V24 HCC 55
  • T40.5X1A Poisoning by cocaine, accidental (unintentional), initial encounter from V24 HCC 55
  • T40.5X4A Poisoning by cocaine, undetermined, initial encounter from V24 HCC 55
  • T40.601A Poisoning by unspecified narcotics, accidental (unintentional), initial encounter from V24 HCC 55
  • T40.604A Poisoning by unspecified narcotics, undetermined, initial encounter from V24 HCC 55
  • T40.691A Poisoning by other narcotics, accidental (unintentional), initial encounter from V24 HCC 55
  • T40.694A Poisoning by other narcotics, undetermined, initial encounter from V24 HCC 55
  • T40.8X1A Poisoning by lysergide [LSD], accidental (unintentional), initial encounter from V24 HCC 55
  • T40.8X4A Poisoning by lysergide [LSD], undetermined, initial encounter from V24 HCC 55
  • T40.901A Poisoning by unspecified psychodysleptics [hallucinogens], accidental (unintentional), initial encounter from V24 HCC 55
  • T40.904A Poisoning by unspecified psychodysleptics [hallucinogens], undetermined, initial encounter from V24 HCC 55
  • T40.991A Poisoning by other psychodysleptics [hallucinogens], accidental (unintentional), initial encounter from V24 HCC 55
  • T40.994A Poisoning by other psychodysleptics [hallucinogens], undetermined, initial encounter from V24 HCC 55
  • T43.601A Poisoning by unspecified psychostimulants, accidental (unintentional), initial encounter from V24 HCC 55
  • T43.604A Poisoning by unspecified psychostimulants, undetermined, initial encounter from V24 HCC 55
  • T43.611A Poisoning by caffeine, accidental (unintentional), initial encounter from V24 HCC 55
  • T43.614A Poisoning by caffeine, undetermined, initial encounter from V24 HCC 55
  • T43.621A Poisoning by amphetamines, accidental (unintentional), initial encounter from V24 HCC 55
  • T43.624A Poisoning by amphetamines, undetermined, initial encounter from V24 HCC 55
  • T43.631A Poisoning by methylphenidate, accidental (unintentional), initial encounter from V24 HCC 55
  • T43.634A Poisoning by methylphenidate, undetermined, initial encounter from V24 HCC 55
  • T43.641A Poisoning by ecstasy, accidental (unintentional), initial encounter from V24 HCC 55
  • T43.644A Poisoning by ecstasy, undetermined, initial encounter from V24 HCC 55
  • T43.651A Poisoning by methamphetamines accidental (unintentional), initial encounter from V24 HCC 55
  • T43.654A Poisoning by methamphetamines, undetermined, initial encounter from V24 HCC 55
  • T43.691A Poisoning by other psychostimulants, accidental (unintentional), initial encounter from V24 HCC 55
  • T43.694A Poisoning by other psychostimulants, undetermined, initial encounter from V24 HCC 55

Every code above carries the full HCC 137 weight when documented and reported on a Medicare Advantage encounter. The code link opens its full page with the complete risk adjustment card.

Questions About HCC 137

What is HCC 137 in the CMS-HCC model?

HCC 137 is CMS-HCC Category 137 (Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications) in the V28 risk adjustment model. It covers 308 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.

What is the RAF weight for HCC 137?

For payment year 2026, HCC 137 adds 0.424 to the RAF score of a community, non-dual, aged beneficiary. The published weights range from 0.297 to 0.502 across the seven payment segments shown above.

Which categories supersede HCC 137?

HCC 135 (Drug Use with Psychotic Complications) and HCC 136 (Alcohol Use with Psychotic Complications) sit above HCC 137 in the hierarchy: when a beneficiary has diagnoses in both, only the more severe category is paid.

Related References

All HCC CategoriesHCC 135 CodesHCC 136 CodesHCC 138 CodesHCC 139 CodesV24 to V28: What ChangedICD-10-CM Code Lookup

Source: Centers for Medicare & Medicaid Services, Payment Year 2026 risk adjustment mapping and model software releases (CMS-HCC V28), applied to the FY 2026 ICD-10-CM code set. ICD List is not affiliated with CMS.