ICD-10 F54
Billable / SpecificPsychological and behavioral factors associated with disorders or diseases classified elsewhere
About ICD-10-CM F54
ICD-10-CM code F54 represents Psychological and behavioral factors associated with disorders or diseases classified elsewhere. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F54). The 2026 edition of ICD-10-CM F54 became effective on October 1, 2025.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under F54. Per CMS ICD-10-CM Tabular 2026.
- Psychological factors affecting physical conditions
Type 2 Excludes
Not included here, the excluded code is not part of F54, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- tension-type headache (G44.2)
Coding Notes
Code First
- the associated physical disorder, such as:
- asthma (J45.-)
- dermatitis (L23-L25)
- gastric ulcer (K25.-)
- mucous colitis (K58.-)
- ulcerative colitis (K51.-)
- urticaria (L50.-)
Medicare LCD Coverage for F54
Local Coverage Determinations (LCDs) from CMS MACs that list F54 as a covered diagnosis.
Showing top 10 of 194 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing F54.
1 Cigna
5 Medicare
CPT Codes Commonly Billed with F54
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 F54 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 |
|---|---|---|
| F54 | 316 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To F54
Other codes in section F50-F59 (Behavioral syndromes associated with physiological disturbances and physical factors).
ICD-10 F54, Billing FAQ
Is ICD-10 code F54 billable? +
Yes, F54 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 F54? +
ICD-10 F54 includes: Psychological factors affecting physical conditions.
What codes are Type 2 Excludes for F54? +
Type 2 Excludes (may be coded together when both conditions exist): tension-type headache (G44.2)
What ICD-9 codes does F54 map to? +
Per CMS GEMs, F54 maps to ICD-9 codes: 316. 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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