2027 ICD-10-CM Diagnosis Code F43.12Post-traumatic stress disorder, chronic

ICD-10-CM Codes›F01–F99›F40-F48›F43

ICD-10-CM F43.12
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

F43.12 is a billable ICD-10-CM diagnosis code for post-traumatic stress disorder, chronic. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 882. Coders also document this condition as chronic post-traumatic stress disorder. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Trauma- and stressor-related disorders.

F43.12 does not risk-adjust for Medicare Advantage under the CMS-HCC V28 model. It still risk-adjusts in the RxHCC Part D (V08) category 133 for payment year 2027.

Code Identity

ICD-10-CM Code
F43.12
Billable Status
Yes — Valid for Submission
Code Describes
Post-traumatic stress disorder, chronic
Short Description
Post-traumatic stress disorder, chronic
Same as the full description in the CMS dataset.
Parent Code
F43.1
Post-traumatic stress disorder (PTSD)

Code Classification

ChapterF01–F99Mental and behavioural disorders
SectionF40-F48Anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders
CategoryF43Reaction to severe stress, and adjustment disorders
This CodeF43.12Post-traumatic stress disorder, chronic

Medicare Risk Adjustment (HCC)Billing

F43.12 does not risk-adjust for Medicare Advantage under the CMS-HCC V28 model, but it maps to payment categories in the other CMS models shown below.

CMS-HCC V28 (Medicare Advantage Payment Model)
Not mapped
no payment category in the model that pays 100% of MA risk scores
Prior Model (CMS-HCC V24)
Not mapped under V24
this diagnosis newly risk-adjusts under the V28 model
Part D (RxHCC)
RxHCC 133 — Anxiety and Other Psychiatric Disorders
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.

  • Chronic post-traumatic stress disorder
  • Chronic post-traumatic stress disorder following military combat
  • Chronic stress disorder
  • Nightmare disorder
  • Nightmares associated with chronic post-traumatic stress disorder
  • Post-trauma response
  • Post-traumatic stress disorder

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to F43.12: 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.

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

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 F43.12, its category, or a range that includes it.

Excludes2 1

These codes carry an Excludes2 note naming F43.12: its condition is not part of those codes, and both may be reported when the patient has both.

  • F93.0 Separation anxiety disorder of childhood
    nonpsychotic mental disorders (F40-F48) names F40-F48, 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 MBD007
Trauma- and stressor-related disorders
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Stress Disorders, Post-Traumatic

    a class of traumatic stress disorders with symptoms that last more than one month.

Patient EducationClinical

Post-Traumatic Stress Disorder

Post-traumatic stress disorder (PTSD) is a mental health disorder that some people develop after they experience or see a traumatic event. The traumatic event may be life-threatening, such as combat, a natural disaster, a car accident, or sexual assault. But sometimes the event is not necessarily a dangerous one.

The full article covers:

  • What is post-traumatic stress disorder (PTSD)?
  • What causes post-traumatic stress disorder (PTSD)?
  • Who is more likely to develop post-traumatic stress disorder (PTSD)?
  • What are the symptoms of post-traumatic stress disorder (PTSD)?
  • How is post-traumatic stress disorder (PTSD) diagnosed?
  • What are the treatments for post-traumatic stress disorder (PTSD)?
  • Can post-traumatic stress disorder (PTSD) be prevented?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert F43.12 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
309.81 Posttraumatic stress dis
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 F43.12Overview

What is the ICD-10 code for post-traumatic stress disorder, chronic?

The ICD-10-CM code for post-traumatic stress disorder, chronic is F43.12 (sometimes written as F4312). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is F43.12 (Post-traumatic stress disorder (PTSD)) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report post-traumatic stress disorder, chronic on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does F43.12 group to?

When post-traumatic stress disorder, chronic is the principal diagnosis on an inpatient stay, it groups to MS-DRG 882 (neuroses Except Depressive), which carries a relative weight of 0.9953. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of F43.12?

Under the General Equivalence Mappings, post-traumatic stress disorder, chronic converts to ICD-9-CM 309.81 (posttraumatic stress dis). The mapping is approximate, so confirm the match fits the documentation.

Does F43.12 risk-adjust for Medicare Advantage payment?

Not for Medicare Advantage: F43.12 maps to no category in the CMS-HCC V28 model. It still risk-adjusts in the RxHCC Part D (V08) category 133 (Anxiety and Other Psychiatric Disorders).