ICD-10 F06.2
Billable / Specific CCPsychotic disorder with delusions due to known physiological condition
About ICD-10-CM F06.2
ICD-10-CM code F06.2 represents Psychotic disorder with delusions due to known physiological condition. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F06). The 2026 edition of ICD-10-CM F06.2 became effective on October 1, 2025.
Coding Tips for F06.2
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
F06.2 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under F06.2. Per CMS ICD-10-CM Tabular 2026.
- Paranoid and paranoid-hallucinatory organic states
- Schizophrenia-like psychosis in epilepsy
Type 2 Excludes
Not included here, the excluded code is not part of F06.2, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- alcohol and drug-induced psychotic disorder (F10-F19 with .150, .250, .950)
- brief psychotic disorder (F23)
- delusional disorder (F22)
- schizophrenia (F20.-)
Inpatient DRG Impact, CC
codes Psychotic disorder with delusions due to known physiological condition. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for F06.2
Local Coverage Determinations (LCDs) from CMS MACs that list F06.2 as a covered diagnosis.
Showing top 10 of 367 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing F06.2.
1 Cigna
5 Medicare
CPT Codes Commonly Billed with F06.2
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 96121 CMS LCD: Billing and Coding: Psychiatric Partial Hospitalization Programs CMS LCD
- 96137 CMS LCD: Billing and Coding: Psychiatric Partial Hospitalization Programs CMS LCD
- 96116 CMS LCD: Billing and Coding: Psychiatric Partial Hospitalization Programs CMS LCD
- 96132 CMS LCD: Billing and Coding: Psychiatric Partial Hospitalization Programs CMS LCD
- 90838 CMS LCD: Billing and Coding: Psychiatric Partial Hospitalization Programs CMS LCD
- G0177 CMS LCD: Billing and Coding: Psychiatric Partial Hospitalization Programs CMS LCD
- 96146 CMS LCD: Billing and Coding: Psychiatric Partial Hospitalization Programs CMS LCD
- 90846 CMS LCD: Billing and Coding: Psychiatric Partial Hospitalization Programs CMS LCD
- G0411 CMS LCD: Billing and Coding: Psychiatric Partial Hospitalization Programs CMS LCD
- 96112 CMS LCD: Billing and Coding: Psychiatric Partial Hospitalization Programs CMS LCD
Convert F06.2 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| F06.2 | 29381 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To F06.2
Other codes in section F01-F09 (Mental disorders due to known physiological conditions).
ICD-10 F06.2, Billing FAQ
Is ICD-10 code F06.2 billable? +
Yes, F06.2 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What other names or terms map to F06.2? +
ICD-10 F06.2 includes: Paranoid and paranoid-hallucinatory organic states; Schizophrenia-like psychosis in epilepsy.
What codes are Type 2 Excludes for F06.2? +
Type 2 Excludes (may be coded together when both conditions exist): alcohol and drug-induced psychotic disorder (F10-F19 with .150, .250, .950); brief psychotic disorder (F23); delusional disorder (F22)
Is F06.2 a CC or MCC for inpatient DRG? +
Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What CPT codes are commonly billed with F06.2? +
Procedures frequently paired with F06.2 include: 96121, 96137, 96116, 96132, 90838.
What ICD-9 codes does F06.2 map to? +
Per CMS GEMs, F06.2 maps to ICD-9 codes: 29381. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on July 16, 2026.
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