ICD-10 F13.239
Billable / Specific HCC v28: 55 CCSedative, hypnotic or anxiolytic dependence with withdrawal, unspecified
About ICD-10-CM F13.239
ICD-10-CM code F13.239 represents Sedative, hypnotic or anxiolytic dependence with withdrawal, unspecified. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F13). The 2026 edition of ICD-10-CM F13.239 became effective on October 1, 2025.
Coding Tips for F13.239
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
F13.239 is a CMS-HCC v28 risk-adjustment code (category 55). 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.
F13.239 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.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under F13.239. Per CMS ICD-10-CM Tabular 2026.
- Sedative, hypnotic, or anxiolytic withdrawal without perceptual disturbances
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 Sedative, hypnotic or anxiolytic dependence with withdrawal, unspecified. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for F13.239
Local Coverage Determinations (LCDs) from CMS MACs that list F13.239 as a covered diagnosis.
Showing top 10 of 162 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing F13.239.
5 Medicare
CPT Codes Commonly Billed with F13.239
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Convert F13.239 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 |
|---|---|---|
| F13.239 | 2920 | 10111 |
| F13.239 | 30410 | 10112 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To F13.239
Other codes in section F10-F19 (Mental and behavioral disorders due to psychoactive substance use).
ICD-10 F13.239, Billing FAQ
Is ICD-10 code F13.239 billable? +
Yes, F13.239 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What other names or terms map to F13.239? +
ICD-10 F13.239 includes: Sedative, hypnotic, or anxiolytic withdrawal without perceptual disturbances.
Does F13.239 affect Medicare Advantage HCC risk adjustment? +
Yes. F13.239 maps to CMS-HCC v28 category 55. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is F13.239 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 ICD-9 codes does F13.239 map to? +
Per CMS GEMs, F13.239 maps to ICD-9 codes: 2920, 30410. 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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