F32.81 — Premenstrual dysphoric disorder
F32.81 is a billable, specific ICD-10-CM code for premenstrual dysphoric disorder. It is valid for submission on a claim.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- premenstrual tension syndrome (N94.3)
Other codes that can never be billed with F32.81
These codes carry an Excludes1 note pointing at F32.81. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading F32.81 alone.
- N94.3Premenstrual tension syndrome
Risk adjustment
F32.81 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
F32.81 is named in 18 Medicare coverage policies — 17 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
- A56645Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
- A56850Billing and Coding: Psychiatric Partial Hospitalization Programs
- A56937Billing and Coding: Psychiatry and Psychology Services
How F32.81 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 F32.81.
- Disorder›premenstrual dysphoric(PMDD)
- Premenstrual›dysphoric disorder(PMDD)
- Syndrome›premenstrual dysphoric
Related codes at this level
Codes that share F32.8. If F32.81 is not quite right, the correct code is usually one of these.
Questions about F32.81
- Is F32.81 a billable ICD-10-CM code?
- Yes. F32.81 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does F32.81 sit in the tabular list?
- Mental, Behavioral and Neurodevelopmental disorders (F01-F99), in the block Mood [affective] disorders (F30-F39).
- What cannot be coded together with F32.81?
- F32.81 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.