Excludes1 pair

F22 vs F30.2

F22 and F30.2 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 F22
mood [affective] disorders with psychotic symptoms (F30.2, F31.2, F31.5, F31.64, F32.3, F33.3)
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)
F30.2

Manic episode, severe with psychotic symptoms

Billable
Chapter 5
Mental, Behavioral and Neurodevelopmental disorders
Section
F30-F39
Use when the record says
  • Manic stupor
  • Mania with mood-congruent psychotic symptoms
  • Mania with mood-incongruent psychotic symptoms
Indexed under
  • Mania › with psychotic symptoms
  • Psychosis, psychotic › mania, manic (single episode)
  • Stupor › manic
  • Disorder › mood › manic episode › with psychotic symptoms
  • Episode › manic › with › psychotic symptoms

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