ICD-10 F16.220
Billable / Specific HCC v28: 55Hallucinogen dependence with intoxication, uncomplicated
About ICD-10-CM F16.220
ICD-10-CM code F16.220 represents Hallucinogen dependence with intoxication, uncomplicated. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F16). The 2026 edition of ICD-10-CM F16.220 became effective on October 1, 2025.
Coding Tips for F16.220
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
F16.220 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.
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.
Medicare LCD Coverage for F16.220
Local Coverage Determinations (LCDs) from CMS MACs that list F16.220 as a covered diagnosis.
Showing top 10 of 217 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing F16.220.
5 Medicare
CPT Codes Commonly Billed with F16.220
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 F16.220 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 |
|---|---|---|
| F16.220 | 2922 | 10111 |
| F16.220 | 30450 | 10112 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To F16.220
Other codes in section F10-F19 (Mental and behavioral disorders due to psychoactive substance use).
ICD-10 F16.220, Billing FAQ
Is ICD-10 code F16.220 billable? +
Yes, F16.220 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does F16.220 affect Medicare Advantage HCC risk adjustment? +
Yes. F16.220 maps to CMS-HCC v28 category 55. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What ICD-9 codes does F16.220 map to? +
Per CMS GEMs, F16.220 maps to ICD-9 codes: 2922, 30450. 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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