F45.41 — Pain disorder exclusively related to psychological factors
F45.41 is a billable, specific ICD-10-CM code for pain disorder exclusively related to psychological factors. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Somatoform pain disorder (persistent)
Other codes that can never be billed with F45.41
These codes carry an Excludes1 note pointing at F45.41. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading F45.41 alone.
Risk adjustment
F45.41 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
F45.41 is named in 15 Medicare coverage policies — 13 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
- A56645Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
- A56937Billing and Coding: Psychiatry and Psychology Services
How F45.41 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 F45.41.
- Dorsalgia›psychogenic
- Pain›psychogenic(persistent) (any site)
- Disorder›pain›exclusively related to psychological factors
- Disorder›persistent›pain(somatoform)
- Disorder›somatoform›pain(persistent)
Related codes at this level
Codes that share F45.4. If F45.41 is not quite right, the correct code is usually one of these.
Questions about F45.41
- Is F45.41 a billable ICD-10-CM code?
- Yes. F45.41 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does F45.41 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).