F21 — Schizotypal disorder
F21 is a billable, specific ICD-10-CM code for schizotypal disorder. 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.
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.
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 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
- A56937Billing and Coding: Psychiatry and Psychology Services
- A57065Billing and Coding: Outpatient Psychiatry and Psychology Services
- A57130Billing and Coding: Psychiatric Codes
How F21 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 F21.
- 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
Questions about F21
- Is F21 a billable ICD-10-CM code?
- Yes. F21 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does F21 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).