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

ICD-10 F68.10

Billable / Specific CC

Factitious disorder imposed on self, unspecified

F68
Block
0
Synonyms
65
LCDs
4
Payer Policies
0
Linked CPTs

About ICD-10-CM F68.10

ICD-10-CM code F68.10 represents Factitious disorder imposed on self, unspecified. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F68). The 2026 edition of ICD-10-CM F68.10 became effective on October 1, 2025.

Coding Tips for F68.10

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

Inpatient DRG impact: CC

F68.10 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Inpatient DRG Impact, CC

codes Factitious disorder imposed on self, unspecified. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for F68.10

Local Coverage Determinations (LCDs) from CMS MACs that list F68.10 as a covered diagnosis.

65 LCDs

Showing top 10 of 65 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT 90847 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT G0560 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT G0017 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT 90837 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT 90792 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT 90791 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT 90833 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT 90845 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT 90840 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT 90834 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing F68.10.

4 policies

1 Cigna

Neuropsychological Testing - (EN0258)
Policy ID: EN_MM_0258

3 Medicare

Billing and Coding: Psychiatric Codes
Policy ID: ART-57130
Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Policy ID: ART-57520
Billing and Coding: Psychological and Neuropsychological Tests
Policy ID: ART-57780

CPT Codes Commonly Billed with F68.10

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

No procedure linkages on file for F68.10

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 F68.10 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
F68.10 30151 10000

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

ICD-10 F68.10, Billing FAQ

Is ICD-10 code F68.10 billable? +

Yes, F68.10 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Is F68.10 a CC or MCC for inpatient DRG? +

Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.

What ICD-9 codes does F68.10 map to? +

Per CMS GEMs, F68.10 maps to ICD-9 codes: 30151. 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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