F29: Unspecified psychosis not due to a substance or known physiological condition
F29 is a billable, specific ICD-10-CM code for unspecified psychosis not due to a substance or known physiological condition. It is valid for submission on a claim.
Check F29 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Psychosis NOS
- Unspecified schizophrenia spectrum and other psychotic disorder
Other codes that can never be billed with F29
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
F29 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
F29 is named in 16 Medicare coverage policies: 15 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
- A56612Billing and Coding: CT of the Head
- A56614Billing and Coding: Psychiatric Inpatient Hospitalization
- A56645Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Alphabetic index entries that lead here
- Psychosis, psychotic
- Disorder›schizophrenia spectrum and other psychotic disorder
- Psychosis, psychotic›confusional
- Psychosis, psychotic›nonorganic
- Schizophrenia, schizophrenic›spectrum and other psychotic disorder
Code history
Unchanged in every release from FY2024 to FY2027.