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135 HCC

Drug Use with Psychotic Complications

CMS Model V28 97 Associated ICD-10 Diagnoses

Relative Risk Score Factors (Coefficients for HCC 135)

Enrollment Model Type Coeff Tag Year Weight Score
CFA HCC135 2026 + 0.702
CFD HCC135 2026 + 1.181
CNA HCC135 2026 + 0.424
CND HCC135 2026 + 0.637
CPA HCC135 2026 + 0.522
CPD HCC135 2026 + 0.922
INS HCC135 2026 + 0.297

Mapped ICD-10-CM Diagnoses (97)

The following diagnoses map directly to HCC 135 under the V28 risk adjustment model:

ICD-10 Code Clinical Diagnosis Description Guideline
F11.150 Opioid abuse with opioid-induced psychotic disorder with delusions Notes ↗
F11.151 Opioid abuse with opioid-induced psychotic disorder with hallucinations Notes ↗
F11.159 Opioid abuse with opioid-induced psychotic disorder, unspecified Notes ↗
F11.250 Opioid dependence with opioid-induced psychotic disorder with delusions Notes ↗
F11.251 Opioid dependence with opioid-induced psychotic disorder with hallucinations Notes ↗
F11.259 Opioid dependence with opioid-induced psychotic disorder, unspecified Notes ↗
F11.950 Opioid use, unspecified with opioid-induced psychotic disorder with delusions Notes ↗
F11.951 Opioid use, unspecified with opioid-induced psychotic disorder with hallucinations Notes ↗
F11.959 Opioid use, unspecified with opioid-induced psychotic disorder, unspecified Notes ↗
F12.150 Cannabis abuse with psychotic disorder with delusions Notes ↗
F12.151 Cannabis abuse with psychotic disorder with hallucinations Notes ↗
F12.159 Cannabis abuse with psychotic disorder, unspecified Notes ↗
F12.250 Cannabis dependence with psychotic disorder with delusions Notes ↗
F12.251 Cannabis dependence with psychotic disorder with hallucinations Notes ↗
F12.259 Cannabis dependence with psychotic disorder, unspecified Notes ↗
F12.950 Cannabis use, unspecified with psychotic disorder with delusions Notes ↗
F12.951 Cannabis use, unspecified with psychotic disorder with hallucinations Notes ↗
F12.959 Cannabis use, unspecified with psychotic disorder, unspecified Notes ↗
F13.131 Sedative, hypnotic or anxiolytic abuse with withdrawal delirium Notes ↗
F13.132 Sedative, hypnotic or anxiolytic abuse with withdrawal with perceptual disturbance Notes ↗
F13.150 Sedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced psychotic disorder with delusions Notes ↗
F13.151 Sedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced psychotic disorder with hallucinations Notes ↗
F13.159 Sedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced psychotic disorder, unspecified Notes ↗
F13.231 Sedative, hypnotic or anxiolytic dependence with withdrawal delirium Notes ↗
F13.232 Sedative, hypnotic or anxiolytic dependence with withdrawal with perceptual disturbance Notes ↗
F13.250 Sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced psychotic disorder with delusions Notes ↗
F13.251 Sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced psychotic disorder with hallucinations Notes ↗
F13.259 Sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced psychotic disorder, unspecified Notes ↗
F13.26 Sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced persisting amnestic disorder Notes ↗
F13.27 Sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced persisting dementia Notes ↗
F13.931 Sedative, hypnotic or anxiolytic use, unspecified with withdrawal delirium Notes ↗
F13.932 Sedative, hypnotic or anxiolytic use, unspecified with withdrawal with perceptual disturbances Notes ↗
F13.950 Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced psychotic disorder with delusions Notes ↗
F13.951 Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced psychotic disorder with hallucinations Notes ↗
F13.959 Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced psychotic disorder, unspecified Notes ↗
F13.96 Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced persisting amnestic disorder Notes ↗
F13.97 Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced persisting dementia Notes ↗
F14.150 Cocaine abuse with cocaine-induced psychotic disorder with delusions Notes ↗
F14.151 Cocaine abuse with cocaine-induced psychotic disorder with hallucinations Notes ↗
F14.159 Cocaine abuse with cocaine-induced psychotic disorder, unspecified Notes ↗
F14.250 Cocaine dependence with cocaine-induced psychotic disorder with delusions Notes ↗
F14.251 Cocaine dependence with cocaine-induced psychotic disorder with hallucinations Notes ↗
F14.259 Cocaine dependence with cocaine-induced psychotic disorder, unspecified Notes ↗
F14.950 Cocaine use, unspecified with cocaine-induced psychotic disorder with delusions Notes ↗
F14.951 Cocaine use, unspecified with cocaine-induced psychotic disorder with hallucinations Notes ↗
F14.959 Cocaine use, unspecified with cocaine-induced psychotic disorder, unspecified Notes ↗
F15.150 Other stimulant abuse with stimulant-induced psychotic disorder with delusions Notes ↗
F15.151 Other stimulant abuse with stimulant-induced psychotic disorder with hallucinations Notes ↗
F15.159 Other stimulant abuse with stimulant-induced psychotic disorder, unspecified Notes ↗
F15.250 Other stimulant dependence with stimulant-induced psychotic disorder with delusions Notes ↗
F15.251 Other stimulant dependence with stimulant-induced psychotic disorder with hallucinations Notes ↗
F15.259 Other stimulant dependence with stimulant-induced psychotic disorder, unspecified Notes ↗
F15.950 Other stimulant use, unspecified with stimulant-induced psychotic disorder with delusions Notes ↗
F15.951 Other stimulant use, unspecified with stimulant-induced psychotic disorder with hallucinations Notes ↗
F15.959 Other stimulant use, unspecified with stimulant-induced psychotic disorder, unspecified Notes ↗
F16.150 Hallucinogen abuse with hallucinogen-induced psychotic disorder with delusions Notes ↗
F16.151 Hallucinogen abuse with hallucinogen-induced psychotic disorder with hallucinations Notes ↗
F16.159 Hallucinogen abuse with hallucinogen-induced psychotic disorder, unspecified Notes ↗
F16.250 Hallucinogen dependence with hallucinogen-induced psychotic disorder with delusions Notes ↗
F16.251 Hallucinogen dependence with hallucinogen-induced psychotic disorder with hallucinations Notes ↗
F16.259 Hallucinogen dependence with hallucinogen-induced psychotic disorder, unspecified Notes ↗
F16.950 Hallucinogen use, unspecified with hallucinogen-induced psychotic disorder with delusions Notes ↗
F16.951 Hallucinogen use, unspecified with hallucinogen-induced psychotic disorder with hallucinations Notes ↗
F16.959 Hallucinogen use, unspecified with hallucinogen-induced psychotic disorder, unspecified Notes ↗
F18.150 Inhalant abuse with inhalant-induced psychotic disorder with delusions Notes ↗
F18.151 Inhalant abuse with inhalant-induced psychotic disorder with hallucinations Notes ↗
F18.159 Inhalant abuse with inhalant-induced psychotic disorder, unspecified Notes ↗
F18.17 Inhalant abuse with inhalant-induced dementia Notes ↗
F18.250 Inhalant dependence with inhalant-induced psychotic disorder with delusions Notes ↗
F18.251 Inhalant dependence with inhalant-induced psychotic disorder with hallucinations Notes ↗
F18.259 Inhalant dependence with inhalant-induced psychotic disorder, unspecified Notes ↗
F18.27 Inhalant dependence with inhalant-induced dementia Notes ↗
F18.950 Inhalant use, unspecified with inhalant-induced psychotic disorder with delusions Notes ↗
F18.951 Inhalant use, unspecified with inhalant-induced psychotic disorder with hallucinations Notes ↗
F18.959 Inhalant use, unspecified with inhalant-induced psychotic disorder, unspecified Notes ↗
F18.97 Inhalant use, unspecified with inhalant-induced persisting dementia Notes ↗
F19.131 Other psychoactive substance abuse with withdrawal delirium Notes ↗
F19.132 Other psychoactive substance abuse with withdrawal with perceptual disturbance Notes ↗
F19.150 Other psychoactive substance abuse with psychoactive substance-induced psychotic disorder with delusions Notes ↗
F19.151 Other psychoactive substance abuse with psychoactive substance-induced psychotic disorder with hallucinations Notes ↗
F19.159 Other psychoactive substance abuse with psychoactive substance-induced psychotic disorder, unspecified Notes ↗
F19.16 Other psychoactive substance abuse with psychoactive substance-induced persisting amnestic disorder Notes ↗
F19.17 Other psychoactive substance abuse with psychoactive substance-induced persisting dementia Notes ↗
F19.231 Other psychoactive substance dependence with withdrawal delirium Notes ↗
F19.232 Other psychoactive substance dependence with withdrawal with perceptual disturbance Notes ↗
F19.250 Other psychoactive substance dependence with psychoactive substance-induced psychotic disorder with delusions Notes ↗
F19.251 Other psychoactive substance dependence with psychoactive substance-induced psychotic disorder with hallucinations Notes ↗
F19.259 Other psychoactive substance dependence with psychoactive substance-induced psychotic disorder, unspecified Notes ↗
F19.26 Other psychoactive substance dependence with psychoactive substance-induced persisting amnestic disorder Notes ↗
F19.27 Other psychoactive substance dependence with psychoactive substance-induced persisting dementia Notes ↗
F19.931 Other psychoactive substance use, unspecified with withdrawal delirium Notes ↗
F19.932 Other psychoactive substance use, unspecified with withdrawal with perceptual disturbance Notes ↗
F19.950 Other psychoactive substance use, unspecified with psychoactive substance-induced psychotic disorder with delusions Notes ↗
F19.951 Other psychoactive substance use, unspecified with psychoactive substance-induced psychotic disorder with hallucinations Notes ↗
F19.959 Other psychoactive substance use, unspecified with psychoactive substance-induced psychotic disorder, unspecified Notes ↗
F19.96 Other psychoactive substance use, unspecified with psychoactive substance-induced persisting amnestic disorder Notes ↗
F19.97 Other psychoactive substance use, unspecified with psychoactive substance-induced persisting dementia Notes ↗
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