F21: Schizotypal disorder
F21 is a billable, specific ICD-10-CM code for schizotypal disorder. It is valid for submission on a claim.
Check F21 with the rest of the claim: free scrubberExcludes2: 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.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Borderline schizophrenia
- Latent schizophrenia
- Latent schizophrenic reaction
- Prepsychotic schizophrenia
- Prodromal schizophrenia
- Pseudoneurotic schizophrenia
- Pseudopsychopathic schizophrenia
- Schizotypal personality disorder
Risk adjustment
F21 risk-adjusts. Under the CMS-HCC V28 model it maps to these categories:
- HCC 153 Personality Disorders; Anorexia/Bulimia Nervosa0.396 RAF
- HCC 153 Personality Disorders; Anorexia/Bulimia Nervosa0.396 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
F21 is named in 7 Medicare coverage policies: 6 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
- A56937Billing and Coding: Psychiatry and Psychology Services
- A57065Billing and Coding: Outpatient Psychiatry and Psychology Services
- A57130Billing and Coding: Psychiatric Codes
Alphabetic index entries that lead here
- Disorder›schizotypal(personality)
- Schizophrenia, schizophrenic›borderline
- Schizophrenia, schizophrenic›incipient
- Schizophrenia, schizophrenic›latent
- Schizophrenia, schizophrenic›prepsychotic
- Schizophrenia, schizophrenic›prodromal
- Schizophrenia, schizophrenic›pseudoneurotic
- Schizophrenia, schizophrenic›pseudopsychopathic
- Disorder›personality›schizotypal
- Reaction›schizophrenic›latent
Code history
Unchanged in every release from FY2024 to FY2027.