Excludes1 pair

F29 vs F53-

F29 and F53 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 F53
psychosis in schizophrenia, schizotypal, delusional, and other psychotic disorders (F20-F29)
F29

Unspecified psychosis not due to a substance or known physiological condition

BillableUnspecified
Chapter 5
Mental, Behavioral and Neurodevelopmental disorders
Section
F20-F29
Use when the record says
  • Psychosis NOS
  • Unspecified schizophrenia spectrum and other psychotic disorder
Indexed under
  • Psychosis, psychotic
  • Disorder › schizophrenia spectrum and other psychotic disorder
  • Psychosis, psychotic › confusional
  • Psychosis, psychotic › nonorganic
  • Schizophrenia, schizophrenic › spectrum and other psychotic disorder
F53

Mental and behavioral disorders associated with the puerperium, not elsewhere classified

Not billable
Chapter 5
Mental, Behavioral and Neurodevelopmental disorders
Section
F50-F59

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