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

ICD-10 F22

Billable / Specific HCC v28: 59

Delusional disorders

F22
Block
8
Synonyms
345
LCDs
17
Payer Policies
0
Linked CPTs

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.

HCC capture: document with MEAT each year

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

CMS-HCC v28 (current)
Category 59
ESRD-HCC
Category 58
RxHCC (Part D)
Category 58

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.

345 LCDs

Showing top 10 of 345 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Psychiatric Inpatient Hospitalization
Article ID: 57052, Effective: 2026-03-26 00:00:00, 422 covered, 0 non-covered
CPT XX000 →
CMS LCD: Billing and Coding: Home Health - Psychiatric Care
Article ID: 56756, Effective: 2023-11-09 00:00:00, 595 covered, 0 non-covered
CPT G0156 →
CMS LCD: Billing and Coding: Home Health - Psychiatric Care
Article ID: 56756, Effective: 2023-11-09 00:00:00, 595 covered, 0 non-covered
CPT G0299 →
CMS LCD: Billing and Coding: Home Health - Psychiatric Care
Article ID: 56756, Effective: 2023-11-09 00:00:00, 595 covered, 0 non-covered
CPT G0152 →
CMS LCD: Billing and Coding: Home Health - Psychiatric Care
Article ID: 56756, Effective: 2023-11-09 00:00:00, 595 covered, 0 non-covered
CPT G0155 →
CMS LCD: Billing and Coding: Home Health - Psychiatric Care
Article ID: 56756, Effective: 2023-11-09 00:00:00, 595 covered, 0 non-covered
CPT G0300 →
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 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing F22.

17 policies

1 Cigna

Neuropsychological Testing - (EN0258)
Policy ID: EN_MM_0258

5 Medicare

Billing and Coding: Psychiatric Inpatient Hospitalization
Policy ID: ART-56614
Billing and Coding: Partial Hospitalization Programs
Policy ID: ART-56685
Billing and Coding: Home Health - Psychiatric Care
Policy ID: ART-56756
Billing and Coding: Psychiatric Partial Hospitalization Programs
Policy ID: ART-56850
Billing and Coding: Psychiatric Inpatient Hospitalization
Policy ID: ART-56865

CPT Codes Commonly Billed with F22

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

No procedure linkages on file for F22

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-10ICD-9Mapping 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).

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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