ICD-10 F29
Billable / Specific HCC v28: 58Unspecified psychosis not due to a substance or known physiological condition
About ICD-10-CM F29
ICD-10-CM code F29 represents Unspecified psychosis not due to a substance or known physiological condition. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F29). The 2026 edition of ICD-10-CM F29 became effective on October 1, 2025.
Coding Tips for F29
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
F29 is a CMS-HCC v28 risk-adjustment code (category 58). 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 F29. Per CMS ICD-10-CM Tabular 2026.
- Psychosis NOS
- Unspecified schizophrenia spectrum and other psychotic disorder
Type 1 Excludes
Pure excludes, these codes can never be coded together with F29. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- mental disorder NOS (F99)
- unspecified mental disorder due to known physiological condition (F09)
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 F29
Local Coverage Determinations (LCDs) from CMS MACs that list F29 as a covered diagnosis.
Showing top 10 of 300 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing F29.
1 Cigna
5 Medicare
CPT Codes Commonly Billed with F29
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 F29 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 |
|---|---|---|
| F29 | 2989 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To F29
Other codes in section F20-F29 (Schizophrenia, schizotypal, delusional, and other non-mood psychotic disorders).
ICD-10 F29, Billing FAQ
Is ICD-10 code F29 billable? +
Yes, F29 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 F29? +
ICD-10 F29 includes: Psychosis NOS; Unspecified schizophrenia spectrum and other psychotic disorder.
What codes are Type 1 Excludes for F29? +
Type 1 Excludes (never code together with F29): mental disorder NOS (F99); unspecified mental disorder due to known physiological condition (F09)
Does F29 affect Medicare Advantage HCC risk adjustment? +
Yes. F29 maps to CMS-HCC v28 category 58. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What ICD-9 codes does F29 map to? +
Per CMS GEMs, F29 maps to ICD-9 codes: 2989. 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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