F20.9 — Schizophrenia, unspecified
F20.9 is a billable, specific ICD-10-CM code for schizophrenia, unspecified. It is valid for submission on a claim.
Risk adjustment
F20.9 risk-adjusts. Under the CMS-HCC V28 model it maps to these categories:
- HCC 151 Schizophrenia0.511 RAF
- HCC 151 Schizophrenia0.511 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
F20.9 is named in 11 Medicare coverage policies — 10 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
- A56614Billing and Coding: Psychiatric Inpatient Hospitalization
- A56645Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
- A56818Billing and Coding: Urine Drug Testing
How F20.9 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 F20.9.
- Schizophrenia, schizophrenic
- Schizophrenia, schizophrenic›childhood type
- Schizophrenia, schizophrenic›chronic undifferentiated
- Syndrome›schizophrenic, of childhood NEC
- Schizophrenia, schizophrenic›undifferentiated›chronic
Related codes at this level
Codes that share F20. If F20.9 is not quite right, the correct code is usually one of these.
Questions about F20.9
- Is F20.9 a billable ICD-10-CM code?
- Yes. F20.9 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does F20.9 sit in the tabular list?
- Mental, Behavioral and Neurodevelopmental disorders (F01-F99), in the block Schizophrenia, schizotypal, delusional, and other non-mood psychotic disorders (F20-F29).