Quick reference
- When to use
- Use F14.20 when the client meets criteria for Cocaine Use Disorder, Moderate. Determine severity by symptom count: mild (2-3), moderate (4-5), severe (6+). Specify current status: in early remission, in sustained remission, or on maintenance therapy.
- Duration
- Early remission: 3-12 months without criteria met (except craving). Sustained remission: 12+ months. On maintenance therapy: receiving agonist medication. Tolerance/withdrawal don't count if on prescribed medication.
- Session codes
- Pair with CPT 90834/90837 for therapy. SBIRT: 99408/99409. Medication management: 99213/99214. Group therapy: 90853. Use 96127 for AUDIT/DAST screening. MAT visits may use specific E/M codes.
- Key indicators
- Impaired control over substance use • Social impairment • Risky use • Pharmacological indicators (tolerance, withdrawal) • Craving • Continued use despite problems • Giving up activities
What F14.20 represents
Moderate cocaine use disorder involves 4-5 diagnostic criteria being met. Note: In DSM-5, cocaine use disorder can also be coded under stimulant use disorder (F15.x).
Key diagnostic criteria
Standard substance use disorder criteria applied to cocaine. 4-5 criteria met for moderate severity.
Documentation essentials
Document pattern of use, route of administration, criteria met, and functional impact.
Differential diagnosis
Distinguish from other stimulant use, cocaine-induced disorders (psychosis, mood, anxiety), and bipolar mania.
Treatment planning
Contingency management, CBT, community reinforcement approach. No FDA-approved medications for cocaine use disorder.
Insurance & billing
Accepted code. Document severity and functional impact.
Updates & changes
May be coded under stimulant use disorder (F15.x) in future coding conventions.
Documentation pitfalls
Screen for cocaine-induced psychiatric conditions. Document route of administration.
References
- American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.).