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ICD-10 Guide
ICD-10 CodesChapter 5: Mental, Behavioral and Neurodevelopmental disordersF06

F06

Billable

Other mental disorders due to known physiological condition

Chapter 5:Mental, Behavioral and Neurodevelopmental disorders

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 F06 is a billable code used to indicate a diagnosis of other mental disorders due to known physiological condition.

Key Diagnostic Point:

F06 encompasses a range of mental disorders that arise as a direct result of identifiable physiological conditions. These disorders can manifest as organic mental syndromes, including delirium, which is characterized by acute confusion, altered consciousness, and cognitive disturbances. Additionally, personality changes may occur due to various medical conditions, such as neurological disorders, metabolic imbalances, or chronic illnesses. The symptoms can vary widely, from mild cognitive impairment to severe behavioral changes, depending on the underlying physiological cause. Accurate diagnosis requires a thorough medical history, physical examination, and often neuroimaging or laboratory tests to identify the physiological condition contributing to the mental disorder. Treatment typically focuses on managing the underlying condition while providing supportive care for the mental health symptoms.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying physiological conditions that can lead to mental disorders.
  • Need for comprehensive documentation linking the physiological condition to the mental disorder.
  • Differentiation from other mental health diagnoses that may not have a physiological basis.
  • Potential for overlapping symptoms with other mental health disorders.

Audit Risk Factors

  • Inadequate documentation linking the mental disorder to the physiological condition.
  • Misdiagnosis or coding of symptoms that could be attributed to other mental health disorders.
  • Failure to document the severity and duration of symptoms.
  • Inconsistent coding practices across different providers.

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed psychiatric evaluation, including history of present illness, mental status examination, and any relevant medical history.

Common Clinical Scenarios

Patients presenting with confusion or personality changes following a stroke or metabolic disorder.

Billing Considerations

Ensure clear documentation of the physiological condition and its impact on mental health.

Neurology

Documentation Requirements

Neurological assessment, imaging results, and laboratory findings that support the diagnosis.

Common Clinical Scenarios

Patients with neurodegenerative diseases exhibiting changes in cognition or behavior.

Billing Considerations

Document the relationship between neurological findings and mental health symptoms.

Coding Guidelines

Inclusion Criteria

Use F06 When
  • According to ICD
  • 10 coding guidelines, F06 should be used when a mental disorder is directly attributable to a known physiological condition
  • Coders must ensure that the physiological condition is well
  • documented and that the mental disorder is a direct consequence of it

Exclusion Criteria

Do NOT use F06 When
  • Exclusions apply for primary mental disorders not linked to physiological causes

Related CPT Codes

90791CPT Code

Psychiatric diagnostic evaluation

Clinical Scenario

Used when assessing a patient with a known physiological condition leading to mental health symptoms.

Documentation Requirements

Comprehensive evaluation notes, including history and mental status examination.

Specialty Considerations

Psychiatrists should document the link between the physiological condition and mental health symptoms.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of mental disorders related to physiological conditions, improving the accuracy of diagnoses and treatment planning. It has also facilitated better tracking of these conditions in healthcare data.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of mental disorders related to physiological conditions, improving the accuracy of diagnoses and treatment planning. It has also facilitated better tracking of these conditions in healthcare data.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of mental disorders related to physiological conditions, improving the accuracy of diagnoses and treatment planning. It has also facilitated better tracking of these conditions in healthcare data.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What types of physiological conditions can lead to F06?

F06 can be associated with a variety of physiological conditions, including neurological disorders (like stroke or traumatic brain injury), metabolic disorders (such as diabetes or thyroid dysfunction), infections (like meningitis), and chronic illnesses (like renal failure).