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HCC 139: Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications

HCC 139, Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications, is one of the 115 payment categories in the CMS-HCC V28 model. 27 ICD-10-CM codes map to it in the payment year 2027 mapping, and a documented diagnosis in the category adds a relative factor of 0.242 to the risk score of a community, non-dual, aged beneficiary (0.207 disabled, 0.000 institutional). It is overridden when a more severe category in its hierarchy is present (HCC 135, HCC 136, HCC 137, HCC 138).

QuickIntell editorial content · Legacy registry date · Review not verified

Data effective
Data currency: ICD-10-CM to HCC mapping PY2027 initial (effective dates of service 2026, payment year 2027); CMS-HCC V28 model software V2826.115.T2 (effective payment year 2027). Next CMS release: PY2027 midyear final mapping (spring 2027) and PY2028 proposed model (February 2027).
Mapped ICD-10-CM codes
27
Factor, community non-dual aged
0.242
Factor, institutional
0.000
Hierarchy
Overridden by HCC 135, HCC 136, HCC 137, HCC 138

Relative factors by segment

Each segment is a separate regression; the factor is added to the beneficiary's demographic factors and other categories, then normalized and reduced by the coding intensity adjustment before it meets the plan's base rate. A factor of 1.000 equals the expected cost of an average beneficiary.

CMS-HCC V28 relative factors for HCC 139 by model segment
SegmentModel codeRelative factor
Community, non-dual, agedCNA_HCC1390.242
Community, non-dual, disabledCND_HCC1390.207
Community, full-benefit dual, agedCFA_HCC1390.478
Community, full-benefit dual, disabledCFD_HCC1390.250
Community, partial-benefit dual, agedCPA_HCC1390.308
Community, partial-benefit dual, disabledCPD_HCC1390.159
Long-term institutionalINS_HCC1390.000

Hierarchy

Hierarchical condition categories pay only the most severe manifestation of a disease. When HCC 135 (Drug Use with Psychotic Complications) or HCC 136 (Alcohol Use with Psychotic Complications) or HCC 137 (Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications) or HCC 138 (Drug Use Disorder, Mild, Uncomplicated, Except Cannabis) is also documented for the same beneficiary, HCC 139 is dropped from the score.

HCC 135
Drug Use with Psychotic Complications · 97 codes · factor 0.424
HCC 136
Alcohol Use with Psychotic Complications · 19 codes · factor 0.424
HCC 137
Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications · 308 codes · factor 0.424
HCC 138
Drug Use Disorder, Mild, Uncomplicated, Except Cannabis · 14 codes · factor 0.423

ICD-10-CM codes that map to HCC 139

27 codes map to this category in the PY2027 initial mapping. Descriptions are the CMS mapping descriptions for the FY2026 code set; a code that is deleted or split in the October code update stays valid for dates of service before the change.

ICD-10-CM codes mapped to HCC 139 in the CMS PY2027 initial mapping
ICD-10-CMDescription
F10130Alcohol abuse with withdrawal, uncomplicated
F10139Alcohol abuse with withdrawal, unspecified
F1014Alcohol abuse with alcohol-induced mood disorder
F10180Alcohol abuse with alcohol-induced anxiety disorder
F10181Alcohol abuse with alcohol-induced sexual dysfunction
F10182Alcohol abuse with alcohol-induced sleep disorder
F10188Alcohol abuse with other alcohol-induced disorder
F1020Alcohol dependence, uncomplicated
F1021Alcohol dependence, in remission
F10220Alcohol dependence with intoxication, uncomplicated
F10221Alcohol dependence with intoxication delirium
F10229Alcohol dependence with intoxication, unspecified
F10230Alcohol dependence with withdrawal, uncomplicated
F10239Alcohol dependence with withdrawal, unspecified
F1024Alcohol dependence with alcohol-induced mood disorder
F10280Alcohol dependence with alcohol-induced anxiety disorder
F10281Alcohol dependence with alcohol-induced sexual dysfunction
F10282Alcohol dependence with alcohol-induced sleep disorder
F10288Alcohol dependence with other alcohol-induced disorder
F1029Alcohol dependence with unspecified alcohol-induced disorder
F10930Alcohol use, unspecified with withdrawal, uncomplicated
F10939Alcohol use, unspecified with withdrawal, unspecified
F1094Alcohol use, unspecified with alcohol-induced mood disorder
F10980Alcohol use, unspecified with alcohol-induced anxiety disorder
F10981Alcohol use, unspecified with alcohol-induced sexual dysfunction
F10982Alcohol use, unspecified with alcohol-induced sleep disorder
F10988Alcohol use, unspecified with other alcohol-induced disorder

Where these codes sat in the V22 model

The V28 recalibration renumbered and regrouped categories; this table shows which legacy V22 categories the same ICD-10 codes belonged to, which is the quickest way to reconcile a V22-era HCC gap list with the current model.

V22 categories that the HCC 139 codes mapped to
V22 HCCCodes
5527

Capturing and defending the category

A category counts for a payment year when a mapped diagnosis is documented at least once during the data collection year by an acceptable provider type at a face-to-face or audio-video encounter, and when the note shows the condition was monitored, evaluated, assessed or treated. Chronic conditions do not carry forward: a category that is not re-documented in the year drops out of the score, which is why annual wellness visits and problem-list reconciliation are where most recapture happens. Risk adjustment data validation audits sample enrollees and ask for the medical record behind each submitted category; an unsupported category is removed and, under the extrapolation rules, the error rate is applied across the contract. The QuickIntell risk adjustment product surfaces suspected and unsupported categories from the chart, and the HCC hub lists every V28 category with its factor and code count.

Frequently asked questions

Which ICD-10 codes map to HCC 139?

27 ICD-10-CM codes map to HCC 139 in the CMS PY2027 initial mapping, for example F10130 Alcohol abuse with withdrawal, uncomplicated; F10139 Alcohol abuse with withdrawal, unspecified; F1014 Alcohol abuse with alcohol-induced mood disorder; F10180 Alcohol abuse with alcohol-induced anxiety disorder. The full list is on this page; a code counts only when it is documented at a face-to-face or video encounter in the data collection year and supported by the record.

How much does HCC 139 add to a risk score?

The V28 relative factor for HCC 139 is 0.242 for a community, non-dual, aged beneficiary, 0.478 for full-benefit dual aged, 0.207 for non-dual disabled and 0.000 for long-term institutional members. A factor of 1.000 equals the expected annual cost of an average beneficiary, so the category's share of the payment follows the plan's base rate for that segment.

Does HCC 139 count together with related categories?

No. Within a hierarchy only the most severe category is paid. HCC 139 is dropped when HCC 135 (Drug Use with Psychotic Complications) or HCC 136 (Alcohol Use with Psychotic Complications) or HCC 137 (Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications) or HCC 138 (Drug Use Disorder, Mild, Uncomplicated, Except Cannabis) is also present.

What has to be documented for HCC 139 to be valid?

The diagnosis must be recorded by an acceptable provider type during a face-to-face or audio-video encounter in the service year, with the note showing that the condition was monitored, evaluated, assessed or treated. Risk adjustment data validation audits recover payment for categories the record does not support, so the code on the claim and the assessment in the note must match.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-02. Verify against the primary file before billing or contracting decisions.

Disclaimer

Relative factors and mappings are reproduced from the CMS risk adjustment model files as an operational reference. Payment depends on the plan's base rate, normalization, the coding intensity adjustment and the enrollee's segment. Not legal, clinical or billing advice.