F09
F09: Unspecified mental disorder due to known physiological condition
Billable / specific codeICD-10-CM
F09 is a billable, specific ICD-10-CM code for unspecified mental disorder due to known physiological condition. It is valid for submission on a claim.
Check F09 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Code first
The underlying condition must be sequenced before this code.
- the underlying physiological condition
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Mental disorder NOS due to known physiological condition
- Organic brain syndrome NOS
- Organic mental disorder NOS
- Organic psychosis NOS
- Symptomatic psychosis NOS
Other codes that can never be billed with F09
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
F09 is named in 9 Medicare coverage policies: 8 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
- A56937Billing and Coding: Psychiatry and Psychology Services
- A57065Billing and Coding: Outpatient Psychiatry and Psychology Services
Alphabetic index entries that lead here
- Deficiency, deficient›cognitive
- Disorder›cognitive
- Organic›brain syndrome
- Organic›mental disorder
- Organic›psychosis
- Psychosis, psychotic›organic
- Psychosis, psychotic›symptomatic
- Syndrome›brain(nonpsychotic)
- Disease, diseased›mental›organic
- Disorder›cognitive›due to general medical condition(secondary to)
- Disorder›mental›organic or symptomatic
- Syndrome›brain›organic
Code history
Unchanged in every release from FY2024 to FY2027.