F28 Other psychotic disorder not due to a substance or known physiological condition

Billable ICD-10-CM code, FY2026.

Applicable to

• Chronic hallucinatory psychosis
• Other specified schizophrenia spectrum and other psychotic disorder

Applies from F28 Other psychotic disorder not due to a substance or known physiological condition

Applicable to

• Chronic hallucinatory psychosis
• Other specified schizophrenia spectrum and other psychotic disorder

Risk adjustment (HCC)

• CMS-HCC V28: HCC 152 — Psychosis, Except Schizophrenia
• RxHCC V08: HCC 130 — Schizophrenia and Other Psychosis
• ESRD V24: HCC 58

MS-DRG index

Defines the logic of DRG(s) 885 in MDC 19.

Approximate ICD-9-CM (GEMs)

• 298.9 Unspecified psychosis (approximate)

Code annotations containing back-references to F28

Back-references to F28

• Type 1 Excludes: F53 Mental and behavioral disorders associated with the puerperium, not elsewhere classified ("psychosis in schizophrenia, schizotypal, delusional, and other psychotic disorders (F20-F29)")
• Type 1 Excludes: R44 Other symptoms and signs involving general sensations and perceptions ("hallucinations in schizophrenia, schizotypal and delusional disorders (F20-F29)")
• Type 1 Excludes: R46 Symptoms and signs involving appearance and behavior ("appearance and behavior in schizophrenia, schizotypal and delusional disorders (F20-F29)")

Back-references to F28

• Type 1 Excludes: F53 Mental and behavioral disorders associated with the puerperium, not elsewhere classified ("psychosis in schizophrenia, schizotypal, delusional, and other psychotic disorders (F20-F29)")
• Type 1 Excludes: R44 Other symptoms and signs involving general sensations and perceptions ("hallucinations in schizophrenia, schizotypal and delusional disorders (F20-F29)")
• Type 1 Excludes: R46 Symptoms and signs involving appearance and behavior ("appearance and behavior in schizophrenia, schizotypal and delusional disorders (F20-F29)")

Diagnosis Index entries for F28

• Disorder (of) › schizophrenia spectrum and other psychotic disorder › specified NEC
• Hallucinosis (chronic)
• Insanity, insane › confusional
• Menopause, menopausal (asymptomatic) (state) › psychosis NEC
• Psychosis, psychotic › hallucinatory, chronic
• Psychosis, psychotic › involutional
• Psychosis, psychotic › nonorganic › specified NEC
• Schizophrenia, schizophrenic › spectrum and other psychotic disorder › specified NEC

Nearby codes

• F28 Other psychotic disorder not due to a substance or known physiological condition (this code)