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ICD-10 Guide
ICD-10 CodesChapter 5: Mental, Behavioral and Neurodevelopmental disordersF29

F29

Billable

Unspecified psychosis not due to a substance or known physiological condition

Chapter 5:Mental, Behavioral and Neurodevelopmental disorders

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

Code Description

ICD-10 F29 is a billable code used to indicate a diagnosis of unspecified psychosis not due to a substance or known physiological condition.

Key Diagnostic Point:

F29 refers to a category of psychotic disorders characterized by the presence of psychotic symptoms such as delusions, hallucinations, disorganized thinking, and impaired functioning, without a clear etiology linked to substance use or identifiable physiological conditions. This diagnosis is often used when the clinician cannot specify the type of psychosis, which may include elements from schizophrenia spectrum disorders or other psychotic disorders. Patients may exhibit significant distress and impairment in social, occupational, or other important areas of functioning. The diagnosis requires careful clinical assessment to rule out other causes, including substance-induced psychosis or medical conditions that could explain the symptoms. Treatment typically involves antipsychotic medications, psychotherapy, and supportive services, with the goal of managing symptoms and improving the patient's quality of life.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Difficulty in differentiating between various psychotic disorders.
  • Need for comprehensive clinical documentation to support the diagnosis.
  • Potential overlap with substance-induced psychosis and other medical conditions.
  • Variability in symptom presentation among patients.

Audit Risk Factors

  • Inadequate documentation of symptoms and their duration.
  • Failure to rule out substance use or medical conditions.
  • Lack of follow-up documentation on treatment response.
  • Misuse of the code for conditions that have a more specific diagnosis.

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Thorough clinical notes detailing the patient's history, symptomatology, and treatment plan.

Common Clinical Scenarios

Initial assessment of a patient presenting with acute psychotic symptoms without clear etiology.

Billing Considerations

Ensure comprehensive assessment to differentiate from other psychotic disorders and document any substance use history.

Primary Care

Documentation Requirements

Detailed patient history and mental status examination, including any referrals to mental health specialists.

Common Clinical Scenarios

Patients presenting with unexplained changes in behavior or mood that may indicate psychosis.

Billing Considerations

Collaboration with mental health professionals for accurate diagnosis and management.

Coding Guidelines

Inclusion Criteria

Use F29 When
  • According to ICD
  • 10 guidelines, F29 should be used when psychotic symptoms are present but cannot be attributed to a substance or known physiological condition
  • Clinicians must document the absence of these factors clearly

Exclusion Criteria

Do NOT use F29 When
  • It is important to note that F29 is a diagnosis of exclusion

Related CPT Codes

99214CPT Code

Established patient office visit, level 4

Clinical Scenario

Used for follow-up visits for patients diagnosed with F29.

Documentation Requirements

Document the patient's mental status, treatment response, and any changes in symptoms.

Specialty Considerations

Psychiatrists should include detailed notes on medication management and therapy progress.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of psychotic disorders, including F29. This specificity aids in better understanding and treatment of psychosis, although it requires coders to be more diligent in documentation and assessment.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of psychotic disorders, including F29. This specificity aids in better understanding and treatment of psychosis, although it requires coders to be more diligent in documentation and assessment.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of psychotic disorders, including F29. This specificity aids in better understanding and treatment of psychosis, although it requires coders to be more diligent in documentation and assessment.

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 key symptoms of F29?

Key symptoms include delusions, hallucinations, disorganized thinking, and significant impairment in functioning. These symptoms must not be attributable to substance use or a medical condition.