F25.9: Schizoaffective disorder, unspecified
F25.9 is a billable, specific ICD-10-CM code for schizoaffective disorder, unspecified. It is valid for submission on a claim.
Check F25.9 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Schizoaffective psychosis NOS
Other codes that can never be billed with F25.9
Their own Excludes1 notes name this code, so the conflict is not listed above.
- F20Schizophrenia
Risk adjustment
F25.9 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
F25.9 is named in 13 Medicare coverage policies: 12 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
- A56645Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
- A56685Billing and Coding: Partial Hospitalization Programs
Alphabetic index entries that lead here
- Schizoaffective psychosis
- Disorder›schizoaffective
- Psychosis, psychotic›schizoaffective
- Psychosis, psychotic›schizophreniform›affective type
Code history
Unchanged in every release from FY2024 to FY2027.