Is F42.4 a billable ICD-10-CM code?

Yes. F42.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does F42.4 sit in the tabular list?

Mental, Behavioral and Neurodevelopmental disorders (F01-F99), in the block Anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders (F40-F48).

What cannot be coded together with F42.4?

F42.4 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

F42.4

F42.4 — Excoriation (skin-picking) disorder

Billable / specific codeICD-10-CM

F42.4 is a billable, specific ICD-10-CM code for excoriation (skin-picking) 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.

factitial dermatitis (L98.1)
other specified behavioral and emotional disorders with onset usually occurring in early childhood and adolescence (F98.8)

Other codes that can never be billed with F42.4

These codes carry an Excludes1 note pointing at F42.4. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading F42.4 alone.

L98.1Factitial dermatitis

Risk adjustment

F42.4 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

F42.4 is named in 18 Medicare coverage policies — 16 listing it as supporting medical necessity, and 2 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
A56865Billing and Coding: Psychiatric Inpatient Hospitalizationnot covered
A56614Billing and Coding: Psychiatric Inpatient Hospitalization
A56756Billing and Coding: Home Health - Psychiatric Care

How F42.4 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 F42.4.

Excoriation›skin picking disorder
Disorder›skin›picking

Related codes at this level

Codes that share F42. If F42.4 is not quite right, the correct code is usually one of these.

Questions about F42.4

Is F42.4 a billable ICD-10-CM code?: Yes. F42.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does F42.4 sit in the tabular list?: Mental, Behavioral and Neurodevelopmental disorders (F01-F99), in the block Anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders (F40-F48).
What cannot be coded together with F42.4?: F42.4 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.