F50-F59 — Behavioral syndromes associated with physiological disturbances and physical factors
ICD-10-CM codes F50-F59 cover behavioral syndromes associated with physiological disturbances and physical factors, within mental, behavioral and neurodevelopmental disorders. The block holds 81 codes across 7 categories, of which 66 are billable and 15 are header codes that cannot be submitted on a claim.
Risk adjustment in F50-F59
0 codes in this block map to a CMS-HCC, which means the diagnosis carries a risk-adjustment payment when it is documented and coded. Under-coding here is money left on the table; over-coding here is what audits are for.
- HCC 153 Personality Disorders; Anorexia/Bulimia Nervosa
- HCC 152 Psychosis, Except Schizophrenia
What else to watch in F50-F59
- 69 codes are named in Medicare coverage policies. An LCD or NCD lists them as supporting medical necessity, or explicitly as not supporting it. Which applies depends on the MAC for your state.
Categories in F50-F59
- F50Eating disorders
- F51Sleep disorders not due to a substance or known physiological condition
- F52Sexual dysfunction not due to a substance or known physiological condition
- F53Mental and behavioral disorders associated with the puerperium, not elsewhere classified
- F54Psychological and behavioral factors associated with disorders or diseases classified elsewhere
- F55Abuse of non-psychoactive substances
- F59Unspecified behavioral syndromes associated with physiological disturbances and physical factors