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

ICD-10 F84.5

Billable / Specific CC

Asperger's syndrome

F84
Block
3
Synonyms
241
LCDs
13
Payer Policies
0
Linked CPTs

About ICD-10-CM F84.5

ICD-10-CM code F84.5 represents Asperger's syndrome. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F84). The 2026 edition of ICD-10-CM F84.5 became effective on October 1, 2025.

Coding Tips for F84.5

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

Inpatient DRG impact: CC

F84.5 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.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under F84.5. Per CMS ICD-10-CM Tabular 2026.

  • Asperger's disorder
  • Autistic psychopathy
  • Schizoid disorder of childhood

Inpatient DRG Impact, CC

codes Asperger's syndrome. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for F84.5

Local Coverage Determinations (LCDs) from CMS MACs that list F84.5 as a covered diagnosis.

241 LCDs

Showing top 10 of 241 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Psychiatric Inpatient Hospitalization
Article ID: 57052, Effective: 2026-03-26 00:00:00, 422 covered, 0 non-covered
CPT XX000 →
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: Psychiatric Partial Hospitalization Programs
Article ID: 57053, Effective: 2026-03-26 00:00:00, 400 covered, 0 non-covered
CPT 90899 →
CMS LCD: Billing and Coding: Psychiatric Partial Hospitalization Programs
Article ID: 57053, Effective: 2026-03-26 00:00:00, 400 covered, 0 non-covered
CPT 96131 →
CMS LCD: Billing and Coding: Psychiatric Partial Hospitalization Programs
Article ID: 57053, Effective: 2026-03-26 00:00:00, 400 covered, 0 non-covered
CPT 96146 →
CMS LCD: Billing and Coding: Psychiatric Partial Hospitalization Programs
Article ID: 57053, Effective: 2026-03-26 00:00:00, 400 covered, 0 non-covered
CPT 96136 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing F84.5.

13 policies

1 Cigna

Intensive Behavioral Interventions - (EN0499)
Policy ID: EN_MM_0499

5 Medicare

Billing and Coding: Psychiatric Inpatient Hospitalization
Policy ID: ART-56614
Billing and Coding: Home Health - Psychiatric Care
Policy ID: ART-56756
Billing and Coding: Psychiatric Inpatient Hospitalization
Policy ID: ART-56865
Billing and Coding: Psychiatry and Psychology Services
Policy ID: ART-56937
Billing and Coding: Psychiatric Inpatient Hospitalization
Policy ID: ART-57052

CPT Codes Commonly Billed with F84.5

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

No procedure linkages on file for F84.5

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 F84.5 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
F84.5 29980 10000
F84.5 29981 10000

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

ICD-10 F84.5, Billing FAQ

Is ICD-10 code F84.5 billable? +

Yes, F84.5 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 F84.5? +

ICD-10 F84.5 includes: Asperger's disorder; Autistic psychopathy; Schizoid disorder of childhood.

Is F84.5 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 F84.5 map to? +

Per CMS GEMs, F84.5 maps to ICD-9 codes: 29980, 29981. 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 June 1, 2026.

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