Excludes1 pair
F20.0 vs F22
F20.0 and F22 are not coded together. ICD-10-CM declares them mutually exclusive with an Excludes1 note — the two conditions are not expected to occur together, so exactly one of them is normally correct for a given encounter. The Official Guidelines carve out one exception: if the two conditions are clearly unrelated to each other, both may be reported.
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
- Schizophrenia, schizophrenic › paranoid (type)
- 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