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ICD-10-CM F13.121: Sedative, hypnotic or anxiolytic abuse with intoxication delirium

F13.121 is the billable ICD-10-CM code for sedative, hypnotic or anxiolytic abuse with intoxication delirium, in category F13 (Sedative, hypnotic, or anxiolytic related disorders) of the Mental and behavioral disorders due to psychoactive substance use section. As a principal diagnosis it groups to MS-DRG 894 Alcohol, Drug Abuse or Dependence, Left AMA, MS-DRG 895 Alcohol, Drug Abuse or Dependence with Rehabilitation Therapy, MS-DRG 896 Alcohol, Drug Abuse or Dependence without Rehabilitation Therapy with MCC (MDC 20 MDC 20: Alcohol or Drug Use or Induced Organic Mental Disorders). It maps to HCC 137 (Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications) in CMS-HCC V28. As a secondary diagnosis it is a CC, excluded with 463 principal diagnoses. 15 LCD billing and coding articles list it as covered.

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: ICD-10-CM code descriptions: FY2027 (effective October 1, 2026); IPPS Table 5 (MS-DRG weights): v44 FY2027 (final rule + CN3) (effective October 1, 2026); ICD-10-CM to HCC mapping: PY2027 initial ICD-10-CM mappings (dates of service 2026) (payment year 2027); Medicare Coverage Database billing and coding articles: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: FY2028 code files, effective October 1, 2027 for the ICD-10-CM code descriptions; FY2028 final rule (August 2027), effective October 1, 2027; an April 1 interim grouper update when CMS issues one for the IPPS Table 5 (MS-DRG weights); PY2028 advance notice (February 2027) and the PY2027 midyear final mapping (spring 2027) for the ICD-10-CM to HCC mapping; weekly, every Thursday for the Medicare Coverage Database billing and coding articles.

Code
F13.121
billable FY2027 ICD-10-CM code
Category
F13 Sedative, hypnotic, or anxiolytic related disorders
Chapter
5: Mental, Behavioral and Neurodevelopmental disorders (F01-F99)
CC/MCC (MS-DRG v44)
CC
CMS-HCC V28
HCC 137
POA reporting
Required

Tabular list notes for F13.121

The tabular list has no notes on F13.121 itself; the notes below apply from its parent headings.

Inherited from F13.1 (Sedative, hypnotic or anxiolytic-related abuse)

Excludes1 (never coded together)
  • sedative, hypnotic or anxiolytic-related dependence (F13.2-)
  • sedative, hypnotic, or anxiolytic use, unspecified (F13.9-)

MS-DRG grouping when F13.121 is the principal diagnosis

MS-DRG v44 groups for F13.121 as principal diagnosis
MDCMS-DRGs
20 MDC 20: Alcohol or Drug Use or Induced Organic Mental Disorders894895896897

The final group also depends on procedures, secondary diagnoses and discharge status; the MS-DRG lookup for F13.121 shows the full grouping logic.

CC/MCC status and inpatient edits

As a secondary diagnosis, F13.121 is a CC under MS-DRG v44, unless the principal diagnosis is one of the 463 codes in its exclusion list. Check F13.121 against a principal diagnosis.

  • Present on admission: a POA indicator is required on inpatient claims.

CMS-HCC V28 risk adjustment

In the PY2027 mapping, F13.121 maps to HCC 137 (Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications). The HCC lookup shows the RAF weight and the hierarchy.

LCD billing and coding articles that list F13.121

15 current Medicare billing and coding articles list F13.121 among the diagnoses that support medical necessity for the services they cover.

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Frequently asked questions

What does ICD-10-CM F13.121 mean?

F13.121 means sedative, hypnotic or anxiolytic abuse with intoxication delirium. It is one of 25 billable codes under F13, sedative, hypnotic, or anxiolytic related disorders.

Which MS-DRG does F13.121 group to?

As the principal diagnosis, F13.121 groups to MS-DRG 894 Alcohol, Drug Abuse or Dependence, Left AMA, MS-DRG 895 Alcohol, Drug Abuse or Dependence with Rehabilitation Therapy, MS-DRG 896 Alcohol, Drug Abuse or Dependence without Rehabilitation Therapy with MCC (MDC 20 MDC 20: Alcohol or Drug Use or Induced Organic Mental Disorders) under MS-DRG v44, before procedures and secondary diagnoses are applied.

Does F13.121 map to an HCC?

Yes: HCC 137, Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications, in the PY2027 CMS-HCC V28 mapping.

Is F13.121 a CC or MCC?

F13.121 is a CC under MS-DRG v44; 463 principal diagnoses exclude it.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

The descriptor and notes are reproduced from the FY2027 ICD-10-CM files; MS-DRG, CC/MCC and HCC facts come from the CMS FY2027 and PY2027 tables. Code from the medical record and the ICD-10-CM Official Guidelines. Not legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.