F59 — Unspecified behavioral syndromes associated with physiological disturbances and physical factors
F59 is a billable, specific ICD-10-CM code for unspecified behavioral syndromes associated with physiological disturbances and physical factors. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Psychogenic physiological dysfunction NOS
Risk adjustment
F59 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
F59 is named in 6 Medicare coverage policies — 5 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
- A57052Billing and Coding: Psychiatric Inpatient Hospitalization
- A57053Billing and Coding: Psychiatric Partial Hospitalization Programs
- A57480Billing and Coding: Psychiatry and Psychology Services
How F59 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 F59.
- Psychological and behavioral factors affecting medical condition
- Dysfunction›psychophysiologic
- Dysfunction›physiological NEC›psychogenic
Questions about F59
- Is F59 a billable ICD-10-CM code?
- Yes. F59 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does F59 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).