Is F06.4 a billable ICD-10-CM code?

Yes. F06.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does F06.4 sit in the tabular list?

Mental, Behavioral and Neurodevelopmental disorders (F01-F99), in the block Mental disorders due to known physiological conditions (F01-F09).

What cannot be coded together with F06.4?

F06.4 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above F06.4 (F06) and apply to it just the same.

F06.4

F06.4 — Anxiety disorder due to known physiological condition

Billable / specific codeICD-10-CM

F06.4 is a billable, specific ICD-10-CM code for anxiety disorder due to known physiological condition. It is valid for submission on a claim.

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.

anxiety disorders due to alcohol and other psychoactive substances (F10-F19 with .180, .280, .980)
anxiety disorders, not due to known physiological condition or unspecified (F40.-, F41.-)

Excludes1 inherited from the categories above F06.4

These are not written on F06.4, but they bind it: a note on a category applies to every code beneath it. Billing F06.4 with anything listed here is a denial.

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

unspecified dementia (F03.-)

Excludes2 inherited from the categories above F06.4

Also inherited, and the opposite of Excludes1: these conditions are not part of F06.4, but a patient can have both, so you may code both.

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

F06.4 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

F06.4 is named in 18 Medicare coverage policies — 17 listing it as supporting medical necessity, and 1 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
A56612Billing and Coding: CT of the Head
A56614Billing and Coding: Psychiatric Inpatient Hospitalization
A56685Billing and Coding: Partial Hospitalization Programs

How F06.4 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to F06.4.

Disorder›anxiety›organic
Disorder›organic›anxiety
Disorder›anxiety›due to›general medical condition

Code history

F06.4 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share F06. If F06.4 is not quite right, the correct code is usually one of these.

Questions about F06.4

Is F06.4 a billable ICD-10-CM code?: Yes. F06.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does F06.4 sit in the tabular list?: Mental, Behavioral and Neurodevelopmental disorders (F01-F99), in the block Mental disorders due to known physiological conditions (F01-F09).
What cannot be coded together with F06.4?: F06.4 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above F06.4 (F06) and apply to it just the same.