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ICD-10 Guide
ICD-10 CodesChapter 5: Mental, Behavioral and Neurodevelopmental disordersF21

F21

Billable

Schizotypal disorder

Chapter 5:Mental, Behavioral and Neurodevelopmental disorders

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

Code Description

ICD-10 F21 is a billable code used to indicate a diagnosis of schizotypal disorder.

Key Diagnostic Point:

Schizotypal disorder, classified under the schizophrenia spectrum and other psychotic disorders in the ICD-10, is characterized by pervasive patterns of social and interpersonal deficits, marked by acute discomfort with close relationships, cognitive or perceptual distortions, and eccentricities of behavior. Individuals with this disorder often exhibit odd beliefs or magical thinking, unusual perceptual experiences, and peculiarities in speech and behavior. These symptoms can lead to significant functional impairment in social and occupational settings. Unlike schizophrenia, individuals with schizotypal disorder do not experience full-blown psychotic episodes but may have transient psychotic symptoms. The disorder typically manifests in early adulthood and can be associated with a family history of schizophrenia or other psychotic disorders. Treatment often involves psychotherapy and may include antipsychotic medications to manage specific symptoms, although the effectiveness of pharmacotherapy can vary. A thorough functional assessment is crucial for understanding the impact of the disorder on daily living and for tailoring appropriate interventions.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating from other psychotic disorders
  • Variability in symptom presentation
  • Need for comprehensive documentation of functional impairment
  • Potential overlap with personality disorders

Audit Risk Factors

  • Inadequate documentation of symptoms
  • Failure to note functional impairment
  • Misclassification with other psychotic disorders
  • Lack of evidence for treatment necessity

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed patient history, symptom assessment, and treatment plans must be documented.

Common Clinical Scenarios

Initial diagnosis, ongoing management, and treatment response evaluations.

Billing Considerations

Documentation should clearly differentiate between schizotypal disorder and other psychotic disorders.

Psychology

Documentation Requirements

Psychological assessments, therapy notes, and progress reports are essential.

Common Clinical Scenarios

Therapeutic interventions and cognitive-behavioral therapy sessions.

Billing Considerations

Focus on behavioral observations and patient self-reports to support diagnosis.

Coding Guidelines

Inclusion Criteria

Use F21 When
  • According to ICD
  • 10 guidelines, F21 should be used when the patient exhibits the characteristic symptoms of schizotypal disorder without meeting the criteria for schizophrenia
  • Documentation must support the diagnosis and include details on the patient's functional status

Exclusion Criteria

Do NOT use F21 When
No specific exclusions found.

Related CPT Codes

90834CPT Code

Psychotherapy, 45 minutes with patient

Clinical Scenario

Used for ongoing therapy sessions for patients diagnosed with F21.

Documentation Requirements

Session notes must detail the therapeutic approach and patient progress.

Specialty Considerations

Psychiatrists and psychologists should ensure alignment between diagnosis and treatment provided.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of schizotypal disorder, improving the accuracy of diagnosis and treatment tracking. It has also facilitated better data collection for research and epidemiological studies.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of schizotypal disorder, improving the accuracy of diagnosis and treatment tracking. It has also facilitated better data collection for research and epidemiological studies.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of schizotypal disorder, improving the accuracy of diagnosis and treatment tracking. It has also facilitated better data collection for research and epidemiological studies.

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 are the primary symptoms of schizotypal disorder?

Primary symptoms include social anxiety, odd beliefs, unusual perceptual experiences, and eccentric behavior. These symptoms can lead to significant impairment in social and occupational functioning.