F48.1: Depersonalization-derealization syndrome

Risk adjustment

F48.1 risk-adjusts. Under the CMS-HCC V28 model it maps to these categories:

• HCC 153 Personality Disorders; Anorexia/Bulimia Nervosa0.396 RAF
• HCC 153 Personality Disorders; Anorexia/Bulimia Nervosa0.396 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

F48.1 is named in 9 Medicare coverage policies: 8 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
• A56756Billing and Coding: Home Health - Psychiatric Care
• A56937Billing and Coding: Psychiatry and Psychology Services
• A57065Billing and Coding: Outpatient Psychiatry and Psychology Services