F06.2

F06.2: Psychotic disorder with delusions due to known physiological condition

Billable / specific codeICD-10-CM

F06.2 is a billable, specific ICD-10-CM code for psychotic disorder with delusions due to known physiological condition. It is valid for submission on a claim.

Check F06.2 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.

alcohol and drug-induced psychotic disorder (F10-F19 with .150, .250, .950)
brief psychotic disorder (F23)
delusional disorder (F22)
schizophrenia (F20.-)

Inclusion terms

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

Paranoid and paranoid-hallucinatory organic states
Schizophrenia-like psychosis in epilepsy

Excludes1 inherited from the categories above F06.2

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 F06.2

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

F06.2 is named in 18 Medicare coverage policies: 17 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
A56612Billing and Coding: CT of the Head
A56614Billing and Coding: Psychiatric Inpatient Hospitalization
A56685Billing and Coding: Partial Hospitalization Programs

Alphabetic index entries that lead here

Psychosis, psychotic›schizophrenia-like, in epilepsy
Disorder›organic›delusional
Disorder›organic›schizophrenia-like
State›organic›paranoid(-hallucinatory)
State›paranoid›organic

Code history

Unchanged in every release from FY2024 to FY2027.