ICD-10 F15.20
Billable / Specific HCC v28: 55 CCOther stimulant dependence, uncomplicated
About ICD-10-CM F15.20
ICD-10-CM code F15.20 represents Other stimulant dependence, uncomplicated. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F15). The 2026 edition of ICD-10-CM F15.20 became effective on October 1, 2025.
Coding Tips for F15.20
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
F15.20 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.
F15.20 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 F15.20. Per CMS ICD-10-CM Tabular 2026.
- Amphetamine type substance use disorder, moderate
- Amphetamine type substance use disorder, severe
- Other or unspecified stimulant use disorder, moderate
- Other or unspecified stimulant use disorder, severe
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
code Other stimulant dependence, uncomplicated. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for F15.20
Local Coverage Determinations (LCDs) from CMS MACs that list F15.20 as a covered diagnosis.
Showing top 10 of 317 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing F15.20.
1 Cigna
5 Medicare
2 Aetna
CPT Codes Commonly Billed with F15.20
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 F15.20 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 |
|---|---|---|
| F15.20 | 30440 | 10000 |
| F15.20 | 30441 | 10000 |
| F15.20 | 30442 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To F15.20
Other codes in section F10-F19 (Mental and behavioral disorders due to psychoactive substance use).
ICD-10 F15.20, Billing FAQ
Is ICD-10 code F15.20 billable? +
Yes, F15.20 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 F15.20? +
ICD-10 F15.20 includes: Amphetamine type substance use disorder, moderate; Amphetamine type substance use disorder, severe; Other or unspecified stimulant use disorder, moderate, and 1 more clinical synonyms.
Does F15.20 affect Medicare Advantage HCC risk adjustment? +
Yes. F15.20 maps to CMS-HCC v28 category 55. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is F15.20 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 F15.20 map to? +
Per CMS GEMs, F15.20 maps to ICD-9 codes: 30440, 30441, 30442. 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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