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

ICD-10 F44.0

Billable / Specific HCC v28: 60

Dissociative amnesia

F44
Block
0
Synonyms
207
LCDs
10
Payer Policies
0
Linked CPTs

About ICD-10-CM F44.0

ICD-10-CM code F44.0 represents Dissociative amnesia. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F44). The 2026 edition of ICD-10-CM F44.0 became effective on October 1, 2025.

Coding Tips for F44.0

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

HCC capture: document with MEAT each year

F44.0 is a CMS-HCC v28 risk-adjustment code (category 60). 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.

Type 1 Excludes

Pure excludes, these codes can never be coded together with F44.0. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • amnesia NOS (R41.3)
  • anterograde amnesia (R41.1)
  • dissociative amnesia with dissociative fugue (F44.1)
  • retrograde amnesia (R41.2)

Type 2 Excludes

Not included here, the excluded code is not part of F44.0, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.

  • alcohol-or other psychoactive substance-induced amnestic disorder (F10, F13, F19 with .26, .96)
  • amnestic disorder due to known physiological condition (F04)
  • postictal amnesia in epilepsy (G40.-)

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 60

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 F44.0

Local Coverage Determinations (LCDs) from CMS MACs that list F44.0 as a covered diagnosis.

207 LCDs

Showing top 10 of 207 total . Click a CPT for full coverage scope.

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: Controlled Substance Monitoring and Drugs of Abuse Testing
Article ID: 56645, Effective: 2024-10-01 00:00:00, 1310 covered, 1 non-covered
CPT G0480 →
CMS LCD: Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Article ID: 56645, Effective: 2024-10-01 00:00:00, 1310 covered, 1 non-covered
CPT G0481 →
CMS LCD: Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Article ID: 56645, Effective: 2024-10-01 00:00:00, 1310 covered, 1 non-covered
CPT G0482 →
CMS LCD: Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Article ID: 56645, Effective: 2024-10-01 00:00:00, 1310 covered, 1 non-covered
CPT G0483 →
CMS LCD: Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Article ID: 56645, Effective: 2024-10-01 00:00:00, 1310 covered, 1 non-covered
CPT 80305 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing F44.0.

10 policies

1 Cigna

Neuropsychological Testing - (EN0258)
Policy ID: EN_MM_0258

5 Medicare

Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Policy ID: ART-56645
Billing and Coding: Home Health - Psychiatric Care
Policy ID: ART-56756
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

CPT Codes Commonly Billed with F44.0

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

No procedure linkages on file for F44.0

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 F44.0 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
F44.0 30012 00000

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

ICD-10 F44.0, Billing FAQ

Is ICD-10 code F44.0 billable? +

Yes, F44.0 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What codes are Type 1 Excludes for F44.0? +

Type 1 Excludes (never code together with F44.0): amnesia NOS (R41.3); anterograde amnesia (R41.1); dissociative amnesia with dissociative fugue (F44.1)

What codes are Type 2 Excludes for F44.0? +

Type 2 Excludes (may be coded together when both conditions exist): alcohol-or other psychoactive substance-induced amnestic disorder (F10, F13, F19 with .26, .96); amnestic disorder due to known physiological condition (F04); postictal amnesia in epilepsy (G40.-)

Does F44.0 affect Medicare Advantage HCC risk adjustment? +

Yes. F44.0 maps to CMS-HCC v28 category 60. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What ICD-9 codes does F44.0 map to? +

Per CMS GEMs, F44.0 maps to ICD-9 codes: 30012. 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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