2026 ICD-10-CM Diagnosis Code F25.9Schizoaffective disorder, unspecified
ICD-10-CM Codes›F01–F99›F20-F29›F25
- Billable — Valid for Submission
- Risk Adjusts — HCC 151
- Chronic Condition
F25.9 is a billable ICD-10-CM diagnosis code for schizoaffective disorder, unspecified. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 885. Coders also document this condition as schizoaffective disorder. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Schizophrenia spectrum and other psychotic disorders.
For Medicare Advantage risk adjustment, F25.9 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 2026.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
F25.9 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 2026.
Source: CMS Payment Year 2026 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.
- Schizoaffective disorder
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Inclusion Terms
- Schizoaffective psychosis NOS
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Disorder (of) See Also: Disease;
schizoaffective F25.9
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Psychotic Disorders
Psychotic disorders are severe mental disorders that cause abnormal thinking and perceptions. People with psychoses lose touch with reality. Two of the main symptoms are delusions and hallucinations. Delusions are false beliefs, such as thinking that someone is plotting against you or that the TV is sending you secret messages.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert F25.9 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About F25.9Overview
What is the ICD-10 code for schizoaffective disorder, unspecified?
The ICD-10-CM code for schizoaffective disorder, unspecified is F25.9 (sometimes written as F259). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
Is F25.9 (Schizoaffective disorders) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report schizoaffective disorder, unspecified on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does F25.9 group to?
When schizoaffective disorder, unspecified is the principal diagnosis on an inpatient stay, it groups to MS-DRG 885 (psychoses), which carries a relative weight of 1.3968. Higher weights mean higher Medicare reimbursement.
What is the ICD-9 equivalent of F25.9?
Under the General Equivalence Mappings, schizoaffective disorder, unspecified converts to ICD-9-CM 295.70 (schizoaffective dis NOS). The mapping is approximate, so confirm the match fits the documentation.
What HCC is F25.9?
F25.9 (schizoaffective disorder, unspecified) 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 2026. 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 F25.9 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, F25.9 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.
