ICD-10 F14 Cocaine Codes: Abuse, Dependence,

Cocaine diagnoses are coded in category F14 of ICD-10-CM — and the most common error in this family happens before the 4th character is even chosen: putting a methamphetamine patient in F14, or a cocaine patient in F15. This guide covers every billable F14 code in the FY2026 code set, the F14-versus-F15 stimulant boundary, withdrawal coding, and what carries medical necessity for a substance with no FDA-approved medication treatment.

All codes and titles are verified against the FY2026 ICD-10-CM code set (effective October 1, 2025) from CDC/NCHS ↗ and CMS ↗; rules cite the ICD-10-CM Official Guidelines FY2026 ↗, Section I.C.5.b. Part of the ICD-10 behavioral health directory.

F14 at a glance

Category F14, Cocaine related disorders, follows the standard three-stem template:

DSM-5-TR folds cocaine into a single stimulant use disorder diagnosis specified by drug type; ICD-10-CM keeps cocaine in its own category. The FY2026 inclusion terms bridge severity the usual way: mild → F14.10, moderate/severe → F14.20, remission at F14.11 (mild) and F14.21 (moderate/severe), all requiring provider documentation per Official Guidelines I.C.5.b.1.

Complete F14 code table (FY2026)

All codes below are valid, billable FY2026 codes; F14.1, F14.22, and other short entries are non-billable headers.

F14.1- — Cocaine abuse

F14.2- — Cocaine dependence

F14.9- — Cocaine use, unspecified

Withdrawal codes (F14.13, F14.23, F14.93) are single five-character codes — no delirium or perceptual-disturbance characters, unlike alcohol or sedatives. Cocaine withdrawal is clinically real (the crash: dysphoria, hypersomnia, craving) but not medically dangerous in the way sedative or alcohol withdrawal is, and the code structure reflects that.

F14 vs F15: cocaine vs every other stimulant

The boundary error that distorts facility data and invites payer questions. The FY2026 tabular draws the line explicitly — F14 carries an Excludes2 note pointing other stimulant-related disorders to F15, and F15 reciprocally excludes cocaine back to F14:

Because it’s an Excludes2 (not Excludes1) relationship, a patient genuinely using both cocaine and methamphetamine can carry an F14 code and an F15 code on the same claim — each substance documented and coded separately. Chart shorthand to translate carefully: “coke,” “crack,” “speedball” (cocaine + opioid → F14 plus F11 ), versus “meth,” “ice,” “Addy” (→ F15).

Hierarchy and remission rules, applied to F14

Same Official Guidelines machinery as every substance family, summarized:

• One code per substance (I.C.5.b.2): use + abuse documented → F14.1-; abuse + dependence (or any combination including dependence) → F14.2-. An intake note saying “cocaine abuse” plus a psychiatric evaluation documenting “cocaine dependence” yields F14.2- only.
• Remission needs provider words (I.C.5.b.1): F14.11 (mild) or F14.21 (moderate/severe) only on explicit provider documentation — negative screens alone don’t authorize the switch.
• Unspecified use is gated (I.C.5.b.3): F14.9- codes require documented use plus a documented link to a related disorder or medical condition.

Documentation requirements

What the note needs before each F14 code group holds up:

• F14.10 / F14.20: provider diagnostic statement with pattern or DSM severity (“cocaine use disorder, severe” → F14.20); route of use and frequency strengthen the record but don’t replace the statement.
• Remission codes: explicit remission language plus severity to pick.11 vs.21.
• Withdrawal (F14.23): documented crash syndrome — dysphoria, fatigue, hypersomnia, craving — tied by the provider to cessation; useful in justifying early-treatment intensity even though it rarely needs medical management.
• Induced disorders: both the syndrome and the causal attribution (“cocaine-induced psychotic disorder with paranoid delusions”) in the provider’s words. Cocaine-induced psychosis that persists after washout should prompt diagnostic re-evaluation, and the coding follows the updated diagnosis.

Billing and medical necessity

The stimulant-specific problem: there is no FDA-approved medication for cocaine use disorder, so medical necessity rests entirely on documented psychosocial treatment intensity and dimensional severity — not on a medication protocol the way opioid claims lean on MAT.

Denial patterns to audit for: abuse-stem codes (F14.10) under residential claims, remission codes contradicting continued-stay requests, and F14/F15 mismatches between the toxicology narrative and the coded diagnosis. Downstream remediation: denial codes in addiction treatment billing and behavioral health RCM.

Treatment planning for cocaine-related diagnoses

With no medication arm, F14 treatment plans live or die on behavioral specificity: craving-management skills, contingency-management incentives where the program offers them, structured scheduling against the binge-crash cycle, and co-occurring mood symptoms tracked explicitly (the post-use crash can mimic — or mask — a primary depressive disorder, and the plan should say which the provider believes it is).

A fictional example: a 35-year-old admitted to PHP with F14.20 (severe cocaine use disorder, documented by criteria count) and F14.24 (cocaine-induced mood disorder); plan goals include daily structured programming ( H0035 ), weekly individual therapy, mood re-assessment at day 14 after sustained abstinence, and step-down criteria tied to craving-scale scores; at re-assessment the mood syndrome has resolved, F14.24 drops off, and the plan steps to IOP under F14.20.

Templates in our treatment plan guide.

More ICD-10 resources

Codes verified against the FY2026 ICD-10-CM tabular list (effective October 1, 2025). Reviewed against each annual ICD-10-CM update.

Stimulant programs run on documentation discipline: ’s EHR connects assessments, treatment plans, and claims in one platform — request a demo.

Reference tables

Common questions

Official sources

• CDC/NCHScdc.gov
• CMScms.gov
• ICD-10-CM Official Guidelines FY2026ftp.cdc.gov