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

ICD-10 F45.42

Billable / Specific

Pain disorder with related psychological factors

F45
Block
0
Synonyms
320
LCDs
14
Payer Policies
58
Linked CPTs

About ICD-10-CM F45.42

ICD-10-CM code F45.42 represents Pain disorder with related psychological factors. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F45). The 2026 edition of ICD-10-CM F45.42 became effective on October 1, 2025.

Coding Notes

Code Also

  • associated acute or chronic pain (G89.-)

Medicare LCD Coverage for F45.42

Local Coverage Determinations (LCDs) from CMS MACs that list F45.42 as a covered diagnosis.

320 LCDs

Showing top 10 of 320 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT G0480 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT G0481 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT G0482 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT G0483 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT 80305 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT G0659 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT 80307 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT 80306 →
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 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing F45.42.

14 policies

1 Cigna

Neuropsychological Testing - (EN0258)
Policy ID: EN_MM_0258

5 Medicare

Billing and Coding: Urine Drug Testing
Policy ID: ART-54799
Billing and Coding: Nerve Conduction Studies and Electromyography
Policy ID: ART-56619
Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Policy ID: ART-56645
Billing and Coding: Urine Drug Testing
Policy ID: ART-56818
Billing and Coding: Urine Drug Testing
Policy ID: ART-56915

CPT Codes Commonly Billed with F45.42

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

58 linkages
  • 80323 CMS LCD: Billing and Coding: Urine Drug Testing CMS LCD
  • 80358 CMS LCD: Billing and Coding: Urine Drug Testing CMS LCD
  • 80326 CMS LCD: Billing and Coding: Urine Drug Testing CMS LCD
  • 80346 CMS LCD: Billing and Coding: Urine Drug Testing CMS LCD
  • 80359 CMS LCD: Billing and Coding: Urine Drug Testing CMS LCD
  • 80363 CMS LCD: Billing and Coding: Urine Drug Testing CMS LCD
  • 80353 CMS LCD: Billing and Coding: Urine Drug Testing CMS LCD
  • 80334 CMS LCD: Billing and Coding: Urine Drug Testing CMS LCD
  • 80369 CMS LCD: Billing and Coding: Urine Drug Testing CMS LCD
  • 80366 CMS LCD: Billing and Coding: Urine Drug Testing CMS LCD

Convert F45.42 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
F45.42 30789 10000

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

ICD-10 F45.42, Billing FAQ

Is ICD-10 code F45.42 billable? +

Yes, F45.42 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What CPT codes are commonly billed with F45.42? +

Procedures frequently paired with F45.42 include: 80323, 80358, 80326, 80346, 80359.

What ICD-9 codes does F45.42 map to? +

Per CMS GEMs, F45.42 maps to ICD-9 codes: 30789. 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 July 17, 2026.

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