2027 ICD-10-CM Diagnosis Code F20.3Undifferentiated schizophrenia
ICD-10-CM Codes›F01–F99›F20-F29›F20
- Billable — Valid for Submission
- Risk Adjusts — HCC 151
- Chronic Condition
F20.3 is a billable ICD-10-CM diagnosis code for undifferentiated schizophrenia. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 885. Coders also document this condition as chronic undifferentiated schizophrenia. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Schizophrenia spectrum and other psychotic disorders.
For Medicare Advantage risk adjustment, F20.3 maps to CMS-HCC Category 151 (Schizophrenia) under the V28 model, adding a risk factor of about 0.511 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
F20.3 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.
Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Chronic undifferentiated schizophrenia
- Chronic undifferentiated schizophrenia with acute exacerbations
- Schizophrenia in remission
- Subchronic schizophrenia with acute exacerbations
- Subchronic undifferentiated schizophrenia
- Subchronic undifferentiated schizophrenia with acute exacerbations
- Undifferentiated schizophrenia
- Undifferentiated schizophrenia in remission
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to F20.3: its own notes plus those printed at F20 and Chapter 5. A note printed at a category, block or chapter applies to every code under it.
Includes
Further defines, or gives examples of, the content of the category.
- disorders of psychological development
Applicable To
Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.
- Atypical schizophrenia
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
- acute schizophrenia-like psychotic disorder (F23)
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
- post-schizophrenic depression (F32.89)
Use Additional Code
Add a second code, after this one, to fully describe the condition.
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name F20.3, its category, or a range that includes it.
Excludes1 4
These codes carry an Excludes1 note naming F20.3: they are not reported together with it, unless the two conditions are unrelated.
- F25 Schizoaffective disordersschizophrenia (F20.-) names F20.-, which includes this code
- F53 Mental and behavioral disorders associated with the puerperium, not elsewhere classified
- R44 Other symptoms and signs involving general sensations and perceptions
- R46 Symptoms and signs involving appearance and behavior
Excludes2 8
These codes carry an Excludes2 note naming F20.3: its condition is not part of those codes, and both may be reported when the patient has both.
- F06.0 Psychotic disorder with hallucinations due to known physiological conditionschizophrenia (F20.-) names F20.-, which includes this code
- F06.2 Psychotic disorder with delusions due to known physiological conditionschizophrenia (F20.-) names F20.-, which includes this code
- F42 Obsessive-compulsive disorderobsessive-compulsive symptoms occurring in schizophrenia (F20.-) names F20.-, which includes this code
- F60.1 Schizoid personality disorderschizophrenia (F20.-) names F20.-, which includes this code
- F63.1 Pyromaniaschizophrenia (F20.-) names F20.-, which includes this code
- F90 Attention-deficit hyperactivity disordersschizophrenia (F20.-) names F20.-, which includes this code
- F91 Conduct disordersschizophrenia (F20.-) names F20.-, which includes this code
- F94.0 Selective mutismschizophrenia (F20.-) names F20.-, which includes this code
Code First 1
These codes say to code first a condition named in the note, and F20.3 is one of the conditions named.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Undifferentiated Type Schizophrenia
a subtype of schizophrenia in which the individual exhibits the characteristic symptoms of schizophrenia but the overall picture is not one of catatonic type, paranoid type, or disorganized type schizophrenia.Schizophrenia
a severe emotional disorder of psychotic depth characteristically marked by a retreat from reality with delusion formation, hallucinations, emotional disharmony, and regressive behavior.
Patient EducationClinical
Schizophrenia
Schizophrenia is a serious brain illness. People who have it may hear voices that aren't there. They may think other people are trying to hurt them. Sometimes they don't make sense when they talk. The disorder makes it hard for them to keep a job or take care of themselves.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert F20.3 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About F20.3Overview
What is the ICD-10 code for undifferentiated schizophrenia?
The ICD-10-CM code for undifferentiated schizophrenia is F20.3 (sometimes written as F203). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is F20.3 (Schizophrenia) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report undifferentiated schizophrenia on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does F20.3 group to?
When undifferentiated schizophrenia is the principal diagnosis on an inpatient stay, it groups to MS-DRG 885 (psychoses), which carries a relative weight of 1.3904. Higher weights mean higher Medicare reimbursement.
Can F20.3 be reported with F23?
Not as a rule. The Excludes1 note on F20.3 lists "acute schizophrenia-like psychotic disorder (F23)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
Does F20.3 need an additional code?
When the condition applies, yes. The Use Additional Code note at F20, which applies to F20.3, reads: code, if applicable, to identify: other specified cognitive deficit (R41.84-). The additional code is reported after F20.3.
What HCC is F20.3?
F20.3 (undifferentiated schizophrenia) maps to CMS-HCC Category 151 (Schizophrenia), commonly written as HCC 151, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 57 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. In the Part D prescription drug model it maps to RxHCC 130.
Does F20.3 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, F20.3 adds a risk adjustment factor of about 0.511 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.304 to 0.591 depending on the payment segment). HCC 151 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 151 category page.
