F54
F54: Psychological and behavioral factors associated with disorders or diseases classified elsewhere
Billable / specific codeICD-10-CM
F54 is a billable, specific ICD-10-CM code for psychological and behavioral factors associated with disorders or diseases classified elsewhere. It is valid for submission on a claim.
Check F54 with the rest of the claim: free scrubberExcludes2: not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
- tension-type headache (G44.2)
Code first
The underlying condition must be sequenced before this code.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Psychological factors affecting physical conditions
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
F54 is named in 8 Medicare coverage policies: 7 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
- A56937Billing and Coding: Psychiatry and Psychology Services
- A57065Billing and Coding: Outpatient Psychiatry and Psychology Services
- A57130Billing and Coding: Psychiatric Codes
Alphabetic index entries that lead here
- Asthma, asthmatic›psychogenic
- Dermatitis›psychogenic
- Dermatosis›psychogenic
- Factor›psychic, associated with diseases classified elsewhere
- Gastritis›nervous
- Psoriasis›psychogenic
- Psychogenic›factors associated with physical conditions
- Colic›mucous›psychogenic
- Colitis›membranous›psychogenic
- Colitis›mucous›psychogenic
- Colitis›spastic›psychogenic
- Colitis›ulcerative›psychogenic
Code history
Unchanged in every release from FY2024 to FY2027.