F20.0 vs F22
F20.0 and F22 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
The official note, declared on F20.0
involutional paranoid state (F22)
F20.0
Paranoid schizophrenia
Billable
- Chapter 5
- Mental, Behavioral and Neurodevelopmental disorders
- Section
- F20-F29
Use when the record says
- Paraphrenic schizophrenia
Indexed under
- Paranoid › schizophrenia
- Paraphrenia, paraphrenic › schizophrenia (late)
- Schizophrenia, schizophrenic › paranoid
- Schizophrenia, schizophrenic › paraphrenic
- Psychosis, psychotic › paranoid › schizophrenic
F22
Delusional disorders
Billable
- Chapter 5
- Mental, Behavioral and Neurodevelopmental disorders
- Section
- F20-F29
Use when the record says
- Delusional dysmorphophobia
- Involutional paranoid state
- Paranoia
- Paranoia querulans
- Paranoid psychosis
- Paranoid state
- Paraphrenia (late)
- Sensitiver Beziehungswahn
Indexed under
- Cotard's syndrome
- Lycanthropy
- Paranoia (querulans)
- Paraphrenia, paraphrenic (late)
- Sander's disease (paranoia)
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027