ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 F07.81

Billable / Specific

Postconcussional syndrome

F07
Block
2
Synonyms
292
LCDs
14
Payer Policies
21
Linked CPTs

About ICD-10-CM F07.81

ICD-10-CM code F07.81 represents Postconcussional syndrome. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F07). The 2026 edition of ICD-10-CM F07.81 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under F07.81. Per CMS ICD-10-CM Tabular 2026.

  • Postcontusional syndrome (encephalopathy)
  • Post-traumatic brain syndrome, nonpsychotic

Type 1 Excludes

Pure excludes, these codes can never be coded together with F07.81. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • current concussion (brain) (S06.0-)
  • postencephalitic syndrome (F07.89)

Use Additional Code

When coding F07.81, also report these additional codes when applicable.

  • code to identify associated post-traumatic headache, if applicable (G44.3-)

Medicare LCD Coverage for F07.81

Local Coverage Determinations (LCDs) from CMS MACs that list F07.81 as a covered diagnosis.

292 LCDs

Showing top 10 of 292 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT 90847 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT G0560 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT G0017 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT 90837 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT 90792 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT 90791 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT 90833 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT 90845 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT 90840 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT 90834 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing F07.81.

14 policies

1 Cigna

Neuropsychological Testing - (EN0258)
Policy ID: EN_MM_0258

5 Medicare

Billing and Coding: Visual Fields Testing
Policy ID: ART-56551
Billing and Coding: CT of the Head
Policy ID: ART-56612
Billing and Coding: Visual Fields Testing
Policy ID: ART-56799
Billing and Coding: Outpatient Speech Language Pathology
Policy ID: ART-56868
Billing and Coding: Psychiatry and Psychology Services
Policy ID: ART-56937

1 Aetna

Cognitive Rehabilitation
Policy ID: CPB-0214

CPT Codes Commonly Billed with F07.81

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

21 linkages
  • 95857 CMS LCD: Billing and Coding: Outpatient Speech Language Pathology CMS LCD
  • 92512 CMS LCD: Billing and Coding: Outpatient Speech Language Pathology CMS LCD
  • 92617 CMS LCD: Billing and Coding: Outpatient Speech Language Pathology CMS LCD
  • 92520 CMS LCD: Billing and Coding: Outpatient Speech Language Pathology CMS LCD
  • 92630 CMS LCD: Billing and Coding: Outpatient Speech Language Pathology CMS LCD
  • 92612 CMS LCD: Billing and Coding: Outpatient Speech Language Pathology CMS LCD
  • 92606 CMS LCD: Billing and Coding: Outpatient Speech Language Pathology CMS LCD
  • 92618 CMS LCD: Billing and Coding: Outpatient Speech Language Pathology CMS LCD
  • 92650 CMS LCD: Billing and Coding: Outpatient Speech Language Pathology CMS LCD
  • 31579 CMS LCD: Billing and Coding: Outpatient Speech Language Pathology CMS LCD

Convert F07.81 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
F07.81 3102 00000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

Codes Adjacent To F07.81

Other codes in section F01-F09 (Mental disorders due to known physiological conditions).

ICD-10 F07.81, Billing FAQ

Is ICD-10 code F07.81 billable? +

Yes, F07.81 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 F07.81? +

ICD-10 F07.81 includes: Postcontusional syndrome (encephalopathy); Post-traumatic brain syndrome, nonpsychotic.

What codes are Type 1 Excludes for F07.81? +

Type 1 Excludes (never code together with F07.81): current concussion (brain) (S06.0-); postencephalitic syndrome (F07.89)

What CPT codes are commonly billed with F07.81? +

Procedures frequently paired with F07.81 include: 95857, 92512, 92617, 92520, 92630.

What ICD-9 codes does F07.81 map to? +

Per CMS GEMs, F07.81 maps to ICD-9 codes: 3102. 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 June 1, 2026.

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