F63.0
F63.0: Pathological gambling
Billable / specific codeICD-10-CM
F63.0 is a billable, specific ICD-10-CM code for pathological gambling. It is valid for submission on a claim.
Check F63.0 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- gambling and betting NOS (Z72.6)
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.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Compulsive gambling
- Gambling disorder
Other codes that can never be billed with F63.0
Their own Excludes1 notes name this code, so the conflict is not listed above.
- Z72.6Gambling and betting
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
F63.0 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
- Betting and gambling›pathological(compulsive)
- Compulsion, compulsive›gambling
- Disorder›gambling
- Gambling›pathological(compulsive)
- Pathologic, pathological›gambling
Code history
Unchanged in every release from FY2024 to FY2027.