F24: Shared psychotic disorder

Risk adjustment

F24 risk-adjusts. Under the CMS-HCC V28 model it maps to these categories:

• HCC 152 Psychosis, Except Schizophrenia0.484 RAF
• HCC 152 Psychosis, Except Schizophrenia0.484 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

F24 is named in 17 Medicare coverage policies: 16 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
• A56614Billing and Coding: Psychiatric Inpatient Hospitalization
• A56685Billing and Coding: Partial Hospitalization Programs
• A56756Billing and Coding: Home Health - Psychiatric Care