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.

Check F06.4 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.

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

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 F06.4

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

F06.4 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