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ICD-10 Guide
ICD-10 CodesF06.8

F06.8

Billable

Other specified mental disorders due to known physiological condition

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

Code Description

ICD-10 F06.8 is a billable code used to indicate a diagnosis of other specified mental disorders due to known physiological condition.

Key Diagnostic Point:

F06.8 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, cognitive impairments, and personality changes. Delirium, characterized by acute confusion and fluctuating levels of consciousness, often occurs in the context of metabolic disturbances, infections, or substance withdrawal. Personality changes may arise from neurological conditions such as traumatic brain injury, stroke, or neurodegenerative diseases, leading to alterations in behavior, mood, and social functioning. The diagnosis requires a thorough assessment to establish a clear link between the physiological condition and the mental disorder, ensuring that other mental health disorders are ruled out. Clinicians must document the underlying physiological condition and its direct impact on the patient's mental state to support the use of this code.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between organic and functional mental disorders
  • Establishing a clear link between the physiological condition and mental symptoms
  • Variability in presentation based on the underlying condition
  • Need for comprehensive documentation to support the diagnosis

Audit Risk Factors

  • Inadequate documentation linking physiological conditions to mental disorders
  • Misclassification of organic versus functional disorders
  • Failure to document the severity and duration of symptoms
  • Inconsistent coding practices across providers

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed clinical notes linking physiological conditions to mental health symptoms, including history and examination findings.

Common Clinical Scenarios

Patients with cognitive decline post-stroke or those experiencing delirium in a hospital setting.

Billing Considerations

Psychiatrists must ensure that the mental disorder is directly attributable to a physiological cause and not a primary psychiatric condition.

Neurology

Documentation Requirements

Comprehensive neurological assessments, imaging results, and laboratory findings that correlate with mental health symptoms.

Common Clinical Scenarios

Patients with traumatic brain injuries exhibiting personality changes or cognitive deficits.

Billing Considerations

Neurologists should document the neurological basis for mental changes to support the use of F06.8.

Coding Guidelines

Inclusion Criteria

Use F06.8 When
  • According to ICD
  • 10 guidelines, F06
  • 8 should be used when a mental disorder is directly linked to a known physiological condition
  • Coders must ensure that the physiological condition is documented and that the mental disorder is not better classified under another code

Exclusion Criteria

Do NOT use F06.8 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

90791CPT Code

Psychiatric diagnostic evaluation

Clinical Scenario

Used when assessing a patient with mental disorders due to physiological conditions.

Documentation Requirements

Comprehensive evaluation notes detailing the patient's history, symptoms, and any physiological conditions.

Specialty Considerations

Psychiatrists should ensure that the evaluation includes a thorough assessment of the physiological factors contributing to the mental disorder.

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 plans. F06.8 provides a distinct category for disorders that do not fit neatly into other classifications, enhancing clinical understanding and billing accuracy.

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 plans. F06.8 provides a distinct category for disorders that do not fit neatly into other classifications, enhancing clinical understanding and billing accuracy.

Reimbursement & Billing Impact

billing accuracy.

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 F06.8?

F06.8 can be associated with a variety of physiological conditions, including infections, metabolic disorders, neurological injuries, and substance use disorders. Each case requires careful evaluation to establish the link between the physiological condition and the mental disorder.