FY2027
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Excludes1 pair

F20- vs F25.0

F20 and F25.0 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
cyclic schizophrenia (F25.0)
F20

Schizophrenia

Not billable
Chapter 5
Mental, Behavioral and Neurodevelopmental disorders
Section
F20-F29
F25.0

Schizoaffective disorder, bipolar type

Billable
Chapter 5
Mental, Behavioral and Neurodevelopmental disorders
Section
F20-F29
Use when the record says
  • Cyclic schizophrenia
  • Schizoaffective disorder, manic type
  • Schizoaffective disorder, mixed type
  • Schizoaffective psychosis, bipolar type
Indexed under
  • Schizophrenia, schizophrenic › cyclic
  • Disorder › schizoaffective › bipolar type
  • Disorder › schizoaffective › manic type
  • Disorder › schizoaffective › mixed type
  • Psychosis, psychotic › schizoaffective › manic type

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