F25.1 — Schizoaffective disorder, depressive type
F25.1 is a billable, specific ICD-10-CM code for schizoaffective disorder, depressive type. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Schizoaffective psychosis, depressive type
Risk adjustment
F25.1 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
F25.1 is named in 19 Medicare coverage policies — 18 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
- A56685Billing and Coding: Partial Hospitalization Programs
How F25.1 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 F25.1.
- Disorder›schizoaffective›depressive type
- Psychosis, psychotic›schizoaffective›depressive type
Related codes at this level
Codes that share F25. If F25.1 is not quite right, the correct code is usually one of these.
Questions about F25.1
- Is F25.1 a billable ICD-10-CM code?
- Yes. F25.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does F25.1 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).