F22 vs F30.2
F22 and F30.2 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.
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 (monopolar)
- Psychosis, psychotic › mania, manic
- Stupor › manic (catatonic)
- Disorder › mood › manic episode › with psychotic symptoms (of)
- 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