ICD-10 F68.1
Non-Billable HeaderFactitious disorder imposed on self
About ICD-10-CM F68.1
ICD-10-CM code F68.1 represents Factitious disorder imposed on self. This is a non-billable header code in the Mental, Behavioral, and Neurodevelopmental chapter (block F68). The 2026 edition of ICD-10-CM F68.1 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under F68.1. Per CMS ICD-10-CM Tabular 2026.
- Compensation neurosis
- Elaboration of physical symptoms for psychological reasons
- Hospital hopper syndrome
- Münchausen's syndrome
- Peregrinating patient
Type 2 Excludes
Not included here, the excluded code is not part of F68.1, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- factitial dermatitis (L98.1)
- person feigning illness (with obvious motivation) (Z76.5)
Medicare LCD Coverage for F68.1
Local Coverage Determinations (LCDs) from CMS MACs that list F68.1 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing F68.1.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but F68.1 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with F68.1
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.
Codes Adjacent To F68.1
Other codes in section F60-F69 (Disorders of adult personality and behavior).
ICD-10 F68.1, Billing FAQ
Is ICD-10 code F68.1 billable? +
No, F68.1 is a non-billable header code. Use a more specific child code from block F68 when submitting claims.
What other names or terms map to F68.1? +
ICD-10 F68.1 includes: Compensation neurosis; Elaboration of physical symptoms for psychological reasons; Hospital hopper syndrome, and 2 more clinical synonyms.
What codes are Type 2 Excludes for F68.1? +
Type 2 Excludes (may be coded together when both conditions exist): factitial dermatitis (L98.1); person feigning illness (with obvious motivation) (Z76.5)
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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