ICD-10 F10.951
Billable / Specific HCC v28: 54 CCAlcohol use, unspecified with alcohol-induced psychotic disorder with hallucinations
About ICD-10-CM F10.951
ICD-10-CM code F10.951 represents Alcohol use, unspecified with alcohol-induced psychotic disorder with hallucinations. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F10). The 2026 edition of ICD-10-CM F10.951 became effective on October 1, 2025.
Coding Tips for F10.951
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
F10.951 is a CMS-HCC v28 risk-adjustment code (category 54). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.
F10.951 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Inpatient DRG Impact, CC
codes Alcohol use, unspecified with alcohol-induced psychotic disorder with hallucinations. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for F10.951
Local Coverage Determinations (LCDs) from CMS MACs that list F10.951 as a covered diagnosis.
Showing top 10 of 244 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing F10.951.
2 Cigna
5 Medicare
CPT Codes Commonly Billed with F10.951
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
Convert F10.951 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| F10.951 | 2913 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To F10.951
Other codes in section F10-F19 (Mental and behavioral disorders due to psychoactive substance use).
ICD-10 F10.951, Billing FAQ
Is ICD-10 code F10.951 billable? +
Yes, F10.951 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does F10.951 affect Medicare Advantage HCC risk adjustment? +
Yes. F10.951 maps to CMS-HCC v28 category 54. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is F10.951 a CC or MCC for inpatient DRG? +
Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What CPT codes are commonly billed with F10.951? +
Procedures frequently paired with F10.951 include: XX000, 90875, 90876.
What ICD-9 codes does F10.951 map to? +
Per CMS GEMs, F10.951 maps to ICD-9 codes: 2913. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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