F12.91 — Cannabis use, unspecified, in remission

Risk adjustment

F12.91 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

F12.91 is named in 12 Medicare coverage policies — 9 listing it as supporting medical necessity, and 3 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

• A52434Health and Behavior Assessment/Intervention – Medical Policy Articlenot covered
• A56562Billing and Coding: Health and Behavior Assessment/Interventionnot covered
• A59718Billing and Coding: Opioid Treatment Programsnot covered
• A56614Billing and Coding: Psychiatric Inpatient Hospitalization