ICD-10 F19.188
Billable / Specific HCC v28: 55Other psychoactive substance abuse with other psychoactive substance-induced disorder
About ICD-10-CM F19.188
ICD-10-CM code F19.188 represents Other psychoactive substance abuse with other psychoactive substance-induced disorder. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F19). The 2026 edition of ICD-10-CM F19.188 became effective on October 1, 2025.
Coding Tips for F19.188
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
F19.188 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 F19.188. Per CMS ICD-10-CM Tabular 2026.
- Other (or unknown) substance use disorder, mild, with other (or unknown) substance induced mild neurocognitive disorder
- Other (or unknown) substance use disorder, mild, with other (or unknown) substance induced obsessive-compulsive or related 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 F19.188
Local Coverage Determinations (LCDs) from CMS MACs that list F19.188 as a covered diagnosis.
Showing top 10 of 369 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing F19.188.
1 Cigna
5 Medicare
CPT Codes Commonly Billed with F19.188
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 F19.188 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 |
|---|---|---|
| F19.188 | 29289 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To F19.188
Other codes in section F10-F19 (Mental and behavioral disorders due to psychoactive substance use).
ICD-10 F19.188, Billing FAQ
Is ICD-10 code F19.188 billable? +
Yes, F19.188 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 F19.188? +
ICD-10 F19.188 includes: Other (or unknown) substance use disorder, mild, with other (or unknown) substance induced mild neurocognitive disorder; Other (or unknown) substance use disorder, mild, with other (or unknown) substance induced obsessive-compulsive or related disorder.
Does F19.188 affect Medicare Advantage HCC risk adjustment? +
Yes. F19.188 maps to CMS-HCC v28 category 55. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What ICD-9 codes does F19.188 map to? +
Per CMS GEMs, F19.188 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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