ICD-10 F06
Non-Billable HeaderOther mental disorders due to known physiological condition
About ICD-10-CM F06
ICD-10-CM code F06 represents Other mental disorders due to known physiological condition. This is a non-billable header code in the Mental, Behavioral, and Neurodevelopmental chapter (block F06). The 2026 edition of ICD-10-CM F06 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Type 1 Excludes
Pure excludes, these codes can never be coded together with F06. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- unspecified dementia (F03.-)
Type 2 Excludes
Not included here, the excluded code is not part of F06, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- delirium due to known physiological condition (F05)
- dementia as classified in F01-F02
- other mental disorders associated with alcohol and other psychoactive substances (F10-F19)
Includes
- mental disorders due to endocrine disorder
- mental disorders due to exogenous hormone
- mental disorders due to exogenous toxic substance
- mental disorders due to primary cerebral disease
- mental disorders due to somatic illness
- mental disorders due to systemic disease affecting the brain
Coding Notes
Code First
- the underlying physiological condition
Medicare LCD Coverage for F06
Local Coverage Determinations (LCDs) from CMS MACs that list F06 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing F06.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but F06 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with F06
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To F06
Other codes in section F01-F09 (Mental disorders due to known physiological conditions).
ICD-10 F06, Billing FAQ
Is ICD-10 code F06 billable? +
No, F06 is a non-billable header code. Use a more specific child code from block F06 when submitting claims.
What codes are Type 1 Excludes for F06? +
Type 1 Excludes (never code together with F06): unspecified dementia (F03.-)
What codes are Type 2 Excludes for F06? +
Type 2 Excludes (may be coded together when both conditions exist): delirium due to known physiological condition (F05); dementia as classified in F01-F02; other mental disorders associated with alcohol and other psychoactive substances (F10-F19)
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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