F06.0

F06.0: Psychotic disorder with hallucinations due to known physiological condition

Billable / specific codeICD-10-CM

F06.0 is a billable, specific ICD-10-CM code for psychotic disorder with hallucinations due to known physiological condition. It is valid for submission on a claim.

Check F06.0 with the rest of the claim: free scrubber

Excludes2: not included here, but may coexist

The excluded condition is not part of this code, but a patient can have both. You may code both.

hallucinations and perceptual disturbance induced by alcohol and other psychoactive substances (F10-F19 with .151, .251, .951)
schizophrenia (F20.-)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Organic hallucinatory state (nonalcoholic)

Excludes1 inherited from the categories above F06.0

A category’s note binds every code beneath it.

Written on F06: Other mental disorders due to known physiological condition

unspecified dementia (F03.-)

Excludes2 inherited from the categories above F06.0

Not part of this code, but both may be coded when both are present.

Written on F06: Other mental disorders due to known physiological condition

delirium due to known physiological condition (F05)
dementia as classified in F01-F02
other mental disorders associated with alcohol and other psychoactive substances (F10-F19)

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

F06.0 is named in 20 Medicare coverage policies: 19 listing it as supporting medical necessity, and 1 listing it as NOT covered. Which one applies depends on your Medicare contractor.

A52434Health and Behavior Assessment/Intervention – Medical Policy Articlenot covered
A54111Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
A56612Billing and Coding: CT of the Head
A56614Billing and Coding: Psychiatric Inpatient Hospitalization

Alphabetic index entries that lead here

Hallucinosis›organic
State›organic›hallucinatory(nonalcoholic)
State›transient organic psychotic NEC›hallucinatory type
Syndrome›organic›hallucinosis
Syndrome›psycho-organic›hallucinatory type
State›psychotic, organic›transient NEC›with›hallucinations

Code history

Unchanged in every release from FY2024 to FY2027.