Is ICD-10-CM code F20 billable?

No, F20 (Schizophrenia) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code F20 belong to?

F20 belongs to Chapter 5 of the ICD-10-CM tabular list: F01–F99 (Mental, Behavioral and Neurodevelopmental Disorders).

F20Not billable, use a more specific code below

Schizophrenia

In Schizophrenia, schizotypal, delusional, and other non-mood psychotic disorders (F20-F29), chapter 5: Mental, Behavioral and Neurodevelopmental Disorders

8 billable codes under F20: 6 are a CC; all map to HCC 151 (Schizophrenia).A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment. An HCC counts toward a Medicare Advantage patient's risk score.

Instructional notes

Excludes1: not coded here, use a different code

brief psychotic disorder (F23)
cyclic schizophrenia (F25.0)
mood [affective] disorders with psychotic symptoms (F30.2, F31.2, F31.5, F31.64, F32.3, F33.3)
schizoaffective disorder (F25.-)
schizophrenic reaction NOS (F23)

Excludes2: not included here, code separately if applicable

schizophrenic reaction in:
alcoholism (F10.15-, F10.25-, F10.95-)
brain disease (F06.2)
epilepsy (F06.2)
psychoactive drug use (F11-F19 with .15. .25, .95)
schizotypal disorder (F21)

Use additional code: add a second code for this, listed after this one

code, if applicable, to identify:
other specified cognitive deficit (R41.84-)

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Covers psychological pain disorders, substance use, abuse, dependence and remission, factitious disorder including Munchausen by proxy, and dementia severity.

Pain disorders related to psychological factors (page 43)
Mental and behavioral disorders due to psychoactive substance use (page 43)
Factitious Disorder (page 44)
Dementia (page 45)

Read Section I.C.5 (page 43)

All codes under F20

F20 can't be used on a claim. Pick a billable code below; grey headings group them.

F20 MS-DRG

As the principal diagnosis, all 8 billable codes under F20 group to MS-DRG 885 (v44.0).

DRG 885 Psychoses

Other codes that refer to F20

Notes on these codes point to F20.

F06.0 Excludes2: schizophrenia (F20.-)
F06.2 Excludes2: schizophrenia (F20.-)
F25 Excludes1: schizophrenia (F20.-)
F42 Excludes2: obsessive-compulsive symptoms occurring in schizophrenia (F20.-)
F53 Excludes1: psychosis in schizophrenia, schizotypal, delusional, and other psychotic disorders (F20-F29)
F60.1 Excludes2: schizophrenia (F20.-)
F63.1 Excludes2: schizophrenia (F20.-)
F90 Excludes2: schizophrenia (F20.-)
F91 Excludes2: schizophrenia (F20.-)
F94.0 Excludes2: schizophrenia (F20.-)
O99.34 Includes: Conditions in F01-F09, F20-F52 and F54-F99
R41.84 Code First: schizophrenia (F20.-)
R44 Excludes1: hallucinations in schizophrenia, schizotypal and delusional disorders (F20-F29)
R46 Excludes1: appearance and behavior in schizophrenia, schizotypal and delusional disorders (F20-F29)

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Schizophrenia

Schizophrenia is a serious brain illness. People who have it may hear voices that aren't there. They may think other people are trying to hurt them. Sometimes they don't make sense when they talk. The disorder makes it hard for them to keep a job or take care of themselves.

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.