ICD-10 F22
Billable / Specific HCC v28: 59Delusional disorders
About ICD-10-CM F22
ICD-10-CM code F22 represents Delusional disorders. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F22). The 2026 edition of ICD-10-CM F22 became effective on October 1, 2025.
Coding Tips for F22
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
F22 is a CMS-HCC v28 risk-adjustment code (category 59). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under F22. Per CMS ICD-10-CM Tabular 2026.
- Delusional dysmorphophobia
- Involutional paranoid state
- Paranoia
- Paranoia querulans
- Paranoid psychosis
- Paranoid state
- Paraphrenia (late)
- Sensitiver Beziehungswahn
Type 1 Excludes
Pure excludes, these codes can never be coded together with F22. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- mood [affective] disorders with psychotic symptoms (F30.2, F31.2, F31.5, F31.64, F32.3, F33.3)
- paranoid schizophrenia (F20.0)
Type 2 Excludes
Not included here, the excluded code is not part of F22, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- paranoid personality disorder (F60.0)
- paranoid psychosis, psychogenic (F23)
- paranoid reaction (F23)
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Medicare LCD Coverage for F22
Local Coverage Determinations (LCDs) from CMS MACs that list F22 as a covered diagnosis.
Showing top 10 of 345 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing F22.
1 Cigna
5 Medicare
CPT Codes Commonly Billed with F22
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.
Convert F22 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 |
|---|---|---|
| F22 | 2970 | 10000 |
| F22 | 2971 | 10000 |
| F22 | 2972 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To F22
Other codes in section F20-F29 (Schizophrenia, schizotypal, delusional, and other non-mood psychotic disorders).
ICD-10 F22, Billing FAQ
Is ICD-10 code F22 billable? +
Yes, F22 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 F22? +
ICD-10 F22 includes: Delusional dysmorphophobia; Involutional paranoid state; Paranoia, and 5 more clinical synonyms.
What codes are Type 1 Excludes for F22? +
Type 1 Excludes (never code together with F22): mood [affective] disorders with psychotic symptoms (F30.2, F31.2, F31.5, F31.64, F32.3, F33.3); paranoid schizophrenia (F20.0)
What codes are Type 2 Excludes for F22? +
Type 2 Excludes (may be coded together when both conditions exist): paranoid personality disorder (F60.0); paranoid psychosis, psychogenic (F23); paranoid reaction (F23)
Does F22 affect Medicare Advantage HCC risk adjustment? +
Yes. F22 maps to CMS-HCC v28 category 59. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What ICD-9 codes does F22 map to? +
Per CMS GEMs, F22 maps to ICD-9 codes: 2970, 2971, 2972. 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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