F43.0 vs R57
F43.0 and R57 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.
The official note, declared on R57
psychic shock (F43.0)
F43.0
Acute stress reaction
Billable
- Chapter 5
- Mental, Behavioral and Neurodevelopmental disorders
- Section
- F40-F48
Use when the record says
- Acute crisis reaction
- Acute reaction to stress
- Combat and operational stress reaction
- Combat fatigue
- Crisis state
- Psychic shock
Indexed under
- Battle exhaustion
- Combat fatigue
- Shellshock (current)
- Crisis › acute reaction
- Crisis › state
R57
Shock, not elsewhere classified
Not billable
- Chapter 18
- Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
- Section
- R50-R69
These two codes sit in different chapters of the Tabular List, which is usually the clearest signal that they describe different underlying processes rather than different degrees of the same one.
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