F54 — Psychological and behavioral factors associated with disorders or diseases classified elsewhere
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.
Excludes2 — 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
F54 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
F54 is named in 8 Medicare coverage policies — 7 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
- A56937Billing and Coding: Psychiatry and Psychology Services
- A57065Billing and Coding: Outpatient Psychiatry and Psychology Services
- A57130Billing and Coding: Psychiatric Codes
How F54 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 F54.
- 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
Questions about F54
- Is F54 a billable ICD-10-CM code?
- Yes. F54 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does F54 sit in the tabular list?
- Mental, Behavioral and Neurodevelopmental disorders (F01-F99), in the block Behavioral syndromes associated with physiological disturbances and physical factors (F50-F59).