2027 ICD-10-CM Diagnosis Code F25.9Schizoaffective disorder, unspecified

ICD-10-CM Codes›F01–F99›F20-F29›F25

ICD-10-CM F25.9
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

F25.9 is a billable ICD-10-CM diagnosis code for schizoaffective disorder, unspecified. 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 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 2027.

Code Identity

ICD-10-CM Code
F25.9
Billable Status
Yes — Valid for Submission
Code Describes
Schizoaffective disorder, unspecified
Short Description
Schizoaffective disorder, unspecified
Same as the full description in the CMS dataset.
Parent Code
F25
Schizoaffective disorders

Code Classification

ChapterF01–F99Mental and behavioural disorders
SectionF20-F29Schizophrenia, schizotypal, delusional, and other non-mood psychotic disorders
CategoryF25Schizoaffective disorders
This CodeF25.9Schizoaffective disorder, unspecified

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 2027.

CMS-HCC V28 Category (Payment Model)
HCC 151— Schizophrenia
Payment HCC · PY 2027 one of 12 ICD-10-CM codes in this category
Risk Adjustment Factor (RAF) Weight
+0.511
community, non-dual, aged · ranges 0.304–0.591 across segments
Hierarchy
Supersedes HCC 152, HCC 153, HCC 154, and HCC 155
less severe related categories are not paid alongside HCC 151
Prior Model (CMS-HCC V24)
HCC 57
V24 retired V28 pays 100% of MA risk scores since PY 2026
Other CMS Models
PACE (CMS-HCC V22): HCC 57 · ESRD (V21): HCC 57 · ESRD (V24): HCC 57
ESRD V21 weights: 0.142 dialysis, 0.217–0.442 functioning graft · ESRD V24 weights: 0.111 dialysis, 0.230–0.572 functioning graft
Part D (RxHCC)
RxHCC 130 — Schizophrenia and Other Psychosis
also risk-adjusts in the Part D prescription drug model (V08)

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.

  • Schizoaffective disorder

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to F25.9: its own notes plus those printed at F25 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.

From Chapter 5 (F01-F99) Mental and behavioural disorders applies to 872 codes
  • 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.

  • Schizoaffective psychosis NOS

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From F25 Schizoaffective disorders applies to 4 codes

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.

From Chapter 5 (F01-F99) Mental and behavioural disorders applies to 872 codes
  • symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99)

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name F25.9, its category, or a range that includes it.

Excludes1 4

These codes carry an Excludes1 note naming F25.9: they are not reported together with it, unless the two conditions are unrelated.

  • F20 Schizophrenia
    schizoaffective disorder (F25.-) names F25.-, which includes this code
  • F53 Mental and behavioral disorders associated with the puerperium, not elsewhere classified
    psychosis in schizophrenia, schizotypal, delusional, and other psychotic disorders (F20-F29) names F20-F29, which includes this code
  • R44 Other symptoms and signs involving general sensations and perceptions
    hallucinations in schizophrenia, schizotypal and delusional disorders (F20-F29) names F20-F29, which includes this code
  • R46 Symptoms and signs involving appearance and behavior
    appearance and behavior in schizophrenia, schizotypal and delusional disorders (F20-F29) names F20-F29, which includes this code

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.

CCSR MBD001
Schizophrenia spectrum and other psychotic disorders
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Schizoaffective Disorder

    a disorder in which the individual suffers from both symptoms that qualify as schizophrenia and symptoms that qualify as a mood disorder (e.g., depression or bipolar disorder) for a substantial portion (but not all) of the active period of the illness; for the remainder of the active period of the illness, the individual suffers from delusions or hallucinations in the absence of prominent mood symptoms.

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.

ICD-9-CM
295.70 Schizoaffective dis NOS
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

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, 2026 through September 30, 2027.

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, 2026 through September 30, 2027.

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 1.3904. Higher weights mean higher Medicare reimbursement.

Can F25.9 be reported with F30.2?

Not as a rule. The Excludes1 note at F25, which applies to F25.9, lists "mood [affective] disorders with psychotic symptoms (F30.2, F31.2, F31.5, F31.64, F32.3, F33.3)". 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).

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 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 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.