ICD-10 F16.980
Billable / Specific HCC v28: 55Hallucinogen use, unspecified with hallucinogen-induced anxiety disorder
About ICD-10-CM F16.980
ICD-10-CM code F16.980 represents Hallucinogen use, unspecified with hallucinogen-induced anxiety disorder. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F16). The 2026 edition of ICD-10-CM F16.980 became effective on October 1, 2025.
Coding Tips for F16.980
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
F16.980 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.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under F16.980. Per CMS ICD-10-CM Tabular 2026.
- Other hallucinogen-induced anxiety disorder, without use disorder
- Phencyclidine induced anxiety disorder, without use disorder
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 F16.980
Local Coverage Determinations (LCDs) from CMS MACs that list F16.980 as a covered diagnosis.
Showing top 10 of 285 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing F16.980.
1 Cigna
5 Medicare
CPT Codes Commonly Billed with F16.980
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 F16.980 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 |
|---|---|---|
| F16.980 | 29289 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To F16.980
Other codes in section F10-F19 (Mental and behavioral disorders due to psychoactive substance use).
ICD-10 F16.980, Billing FAQ
Is ICD-10 code F16.980 billable? +
Yes, F16.980 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 F16.980? +
ICD-10 F16.980 includes: Other hallucinogen-induced anxiety disorder, without use disorder; Phencyclidine induced anxiety disorder, without use disorder.
Does F16.980 affect Medicare Advantage HCC risk adjustment? +
Yes. F16.980 maps to CMS-HCC v28 category 55. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What ICD-9 codes does F16.980 map to? +
Per CMS GEMs, F16.980 maps to ICD-9 codes: 29289. 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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