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

ICD-10 F09

Billable / Specific

Unspecified mental disorder due to known physiological condition

F09
Block
5
Synonyms
208
LCDs
9
Payer Policies
0
Linked CPTs

About ICD-10-CM F09

ICD-10-CM code F09 represents Unspecified mental disorder due to known physiological condition. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F09). The 2026 edition of ICD-10-CM F09 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under F09. Per CMS ICD-10-CM Tabular 2026.

  • Mental disorder NOS due to known physiological condition
  • Organic brain syndrome NOS
  • Organic mental disorder NOS
  • Organic psychosis NOS
  • Symptomatic psychosis NOS

Type 1 Excludes

Pure excludes, these codes can never be coded together with F09. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • mild neurocognitive disorder due to known physiological condition (F06.7-)
  • psychosis NOS (F29)

Coding Notes

Code First

  • the underlying physiological condition

Medicare LCD Coverage for F09

Local Coverage Determinations (LCDs) from CMS MACs that list F09 as a covered diagnosis.

208 LCDs

Showing top 10 of 208 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 F09.

9 policies

1 Cigna

Neuropsychological Testing - (EN0258)
Policy ID: EN_MM_0258

5 Medicare

Billing and Coding: CT of the Head
Policy ID: ART-56612
Billing and Coding: Psychiatry and Psychology Services
Policy ID: ART-56937
Billing and Coding: Outpatient Psychiatry and Psychology Services
Policy ID: ART-57065
Billing and Coding: Psychiatric Codes
Policy ID: ART-57130
Billing and Coding: MRI and CT Scans of the Head and Neck
Policy ID: ART-57204

CPT Codes Commonly Billed with F09

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

No procedure linkages on file for F09

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.

Convert F09 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
F09 3109 10000

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

Codes Adjacent To F09

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

ICD-10 F09, Billing FAQ

Is ICD-10 code F09 billable? +

Yes, F09 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 F09? +

ICD-10 F09 includes: Mental disorder NOS due to known physiological condition; Organic brain syndrome NOS; Organic mental disorder NOS, and 2 more clinical synonyms.

What codes are Type 1 Excludes for F09? +

Type 1 Excludes (never code together with F09): mild neurocognitive disorder due to known physiological condition (F06.7-); psychosis NOS (F29)

What ICD-9 codes does F09 map to? +

Per CMS GEMs, F09 maps to ICD-9 codes: 3109. 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 May 31, 2026.

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