F53.1 — Puerperal psychosis
F53.1 is a billable, specific ICD-10-CM code for puerperal psychosis. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Postpartum psychosis
- Puerperal psychosis, NOS
Other codes that can never be billed with F53.1
These codes carry an Excludes1 note pointing at F53.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading F53.1 alone.
- O90.6Postpartum mood disturbance
Risk adjustment
F53.1 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 152 Psychosis, Except Schizophrenia0.484 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
F53.1 is named in 18 Medicare coverage policies — 18 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56612Billing and Coding: CT of the Head
- A56614Billing and Coding: Psychiatric Inpatient Hospitalization
- A56685Billing and Coding: Partial Hospitalization Programs
- A56756Billing and Coding: Home Health - Psychiatric Care
How F53.1 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to F53.1.
- Psychosis, psychotic›postpartum(NOS)
- Psychosis, psychotic›puerperal(NOS)
- Puerperal, puerperium›psychosis(NOS)
- Pregnancy›complicated by›psychosis or psychoneurosis(puerperal)
Related codes at this level
Codes that share F53. If F53.1 is not quite right, the correct code is usually one of these.
Questions about F53.1
- Is F53.1 a billable ICD-10-CM code?
- Yes. F53.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does F53.1 sit in the tabular list?
- Mental, Behavioral and Neurodevelopmental disorders (F01-F99), in the block Behavioral syndromes associated with physiological disturbances and physical factors (F50-F59).