2027 ICD-10-CM Diagnosis Code F63.0Pathological gambling
ICD-10-CM Codes›F01–F99›F60-F69›F63
- Billable — Valid for Submission
- Chronic Condition
F63.0 is a billable ICD-10-CM diagnosis code for pathological gambling. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 883. Coders also document this condition as compulsive gambling. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Miscellaneous mental and behavioral disorders/conditions.
F63.0 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
Code Classification
Medicare Risk Adjustment (HCC)Billing
F63.0 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.
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.
- Compulsive gambling
- Gambling disorder predominantly offline
- Gambling disorder predominantly online
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to F63.0: its own notes plus those printed at F63 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.
- Compulsive gambling
- Gambling disorder
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
- gambling and betting NOS (Z72.6)
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 F63.0, its category, or a range that includes it.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Disorder (of) See Also: Disease;
gambling F63.0
Pathologic, pathological See Also: condition;
gambling F63.0
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Pathological Gambling
a disorder characterized by a preoccupation with gambling and the excitement that gambling with increasing risk provides. pathological gamblers are unable to cut back on their gambling, despite the fact that it may lead them to lie, steal, or lose a significant relationship, job, or educational opportunity.
Patient EducationClinical
Compulsive Gambling
Many people enjoy gambling, whether it's betting on a horse or playing poker on the Internet. Most people who gamble don't have a problem, but some lose control of their gambling. Signs of problem gambling include :
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert F63.0 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About F63.0Overview
What is the ICD-10 code for pathological gambling?
The ICD-10-CM code for pathological gambling is F63.0 (sometimes written as F630). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is F63.0 (Impulse disorders) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report pathological gambling on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does F63.0 group to?
When pathological gambling is the principal diagnosis on an inpatient stay, it groups to MS-DRG 883 (disorders of Personality and Impulse Control), which carries a relative weight of 1.7398. Higher weights mean higher Medicare reimbursement.
Can F63.0 be reported with Z72.6?
Not as a rule. The Excludes1 note on F63.0 lists "gambling and betting NOS (Z72.6)". 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 F63.0?
Under the General Equivalence Mappings, pathological gambling converts to ICD-9-CM 312.31 (pathological gambling). The mapping is a direct match.
Does F63.0 risk-adjust for Medicare Advantage payment?
Not for Medicare Advantage: F63.0 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).
