F50.23 Bulimia nervosa, severe

Billable ICD-10-CM code, FY2026. Acts as a Complication or Comorbidity (CC) as a secondary diagnosis.

Applicable to

• Bulimia nervosa with 8-13 episodes of inappropriate compensatory behavior per week

Applies from F50 Eating disorders

Excludes1 (never code together)

• anorexia NOS (R63.0)
• feeding problems of newborn (P92.-)
• polyphagia (R63.2)

Excludes2 (not included here)

• feeding difficulties (R63.3-)
• feeding disorder in infancy or childhood (F98.2-)

Applies from F50.2 Bulimia nervosa

Applicable to

• Bulimia NOS
• Hyperorexia nervosa

Excludes1 (never code together)

• anorexia nervosa, binge eating/purging type (F50.02-)

Risk adjustment (HCC)

• CMS-HCC V28: HCC 153 — Personality Disorders; Anorexia/Bulimia Nervosa
• RxHCC V08: HCC 133 — Anxiety and Other Psychiatric Disorders

MS-DRG index

Defines the logic of DRG(s) 887 in MDC 19.

Code annotations containing back-references to F50.23

Back-references to F50.2

• Type 1 Excludes: F50.02 Anorexia nervosa, binge eating/purging type ("bulimia nervosa (F50.2-)")
• Type 1 Excludes: R11 Nausea and vomiting ("vomiting associated with bulimia nervosa (F50.2-)")
• Type 1 Excludes: R63 Symptoms and signs concerning food and fluid intake ("bulimia NOS (F50.2-)")

Back-references to F50

• Type 2 Excludes: F98.2 Other feeding disorders of infancy and childhood ("anorexia nervosa and other eating disorders (F50.-)")
• Type 1 Excludes: P92 Feeding problems of newborn ("eating disorders (F50.-)")
• Type 2 Excludes: R63.3 Feeding difficulties ("eating disorders (F50.-)")
• Type 1 Excludes: Z72.4 Inappropriate diet and eating habits ("eating disorders (F50.-)")

Nearby codes

• F50.029 Anorexia nervosa, binge eating/purging type, unspecified
• F50.2 Bulimia nervosa
• F50.20 Bulimia nervosa, unspecified
• F50.21 Bulimia nervosa, mild
• F50.22 Bulimia nervosa, moderate
• F50.23 Bulimia nervosa, severe (this code)
• F50.24 Bulimia nervosa, extreme
• F50.25 Bulimia nervosa, in remission
• F50.8 Other eating disorders
• F50.81 Binge eating disorder
• F50.810 Binge eating disorder, mild