2027 ICD-10-CM Diagnosis Code F29Unspecified psychosis not due to a substance or known physiological condition
F29 is a billable ICD-10-CM diagnosis code for unspecified psychosis not due to a substance or known physiological condition. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 885, 974 through 976. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Schizophrenia spectrum and other psychotic disorders.
For Medicare Advantage risk adjustment, F29 maps to CMS-HCC Category 152 (Psychosis, Except Schizophrenia) under the V28 model, adding a risk factor of about 0.484 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
F29 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.
- Atypical psychosis
- Cognitive impairment co-occurrent and due to primary psychotic disorder
- High level of psychoticism
- Level of psychoticism - finding
- Mental disorder in mother complicating childbirth
- Mental disorder in mother complicating pregnancy
- Negative symptoms co-occurrent and due to primary psychotic disorder
- Negativism
- Non-organic psychosis
- Positive symptoms co-occurrent and due to primary psychotic disorder
- Psychiatric sign or symptom
- Psychomotor symptom co-occurrent and due to psychotic disorder
- Psychotic disorder
- Psychotic disorder in mother complicating childbirth
- Psychotic disorder in mother complicating pregnancy
- Psychotic disorder with insight present
- Psychotic symptom finding
- Psychotic symptom present
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to F29: its own notes plus those printed at 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.
- Psychosis NOS
- Unspecified schizophrenia spectrum and other psychotic disorder
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
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.
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name F29, its category, or a range that includes it.
Excludes1 4
These codes carry an Excludes1 note naming F29: they are not reported together with it, unless the two conditions are unrelated.
- F09 Unspecified mental disorder due to known physiological conditionpsychosis NOS (F29)
- 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
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Disorder (of) See Also: Disease;
confusional F29
nonorganic F29
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Psychotic Disorders
disorders in which there is a loss of ego boundaries or a gross impairment in reality testing with delusions or prominent hallucinations. (from dsm-iv, 1994)
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 F29 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About F29Overview
Is F29 a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report unspecified psychosis not due to a substance or known physiological condition on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does F29 group to?
When unspecified psychosis not due to a substance or known physiological condition is the principal diagnosis on an inpatient stay, it groups to MS-DRG 974, 976, 975, 885, with relative weights from 0.7879 to 3.0488 depending on complications. Higher weights mean higher Medicare reimbursement.
Can F29 be reported with F99?
Not as a rule. The Excludes1 note on F29 lists "mental disorder NOS (F99)". 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 F29?
Under the General Equivalence Mappings, unspecified psychosis not due to a substance or known physiological condition converts to ICD-9-CM 298.9 (psychosis NOS). The mapping is approximate, so confirm the match fits the documentation.
What HCC is F29?
F29 (unspecified psychosis not due to a substance or known physiological condition) maps to CMS-HCC Category 152 (Psychosis, Except Schizophrenia), commonly written as HCC 152, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 58 under the retired V24 model. It also maps in the ESRD (V24) model. In the Part D prescription drug model it maps to RxHCC 130.
Does F29 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, F29 adds a risk adjustment factor of about 0.484 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.208 to 0.579 depending on the payment segment). A more severe related category (HCC 151) supersedes it when both are reported. See the full factor table on the HCC 152 category page.
