F44.6 vs R20
F44.6 and R20 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 R20
dissociative anesthesia and sensory loss (F44.6)
F44.6
Conversion disorder with sensory symptom or deficit
Billable
- Chapter 5
- Mental, Behavioral and Neurodevelopmental disorders
- Section
- F40-F48
Use when the record says
- Conversion disorder with anesthesia or sensory loss
- Conversion disorder with special sensory symptoms
- Dissociative anesthesia and sensory loss
- Psychogenic deafness
Indexed under
- Amaurosis › hysterical (acquired) (congenital)
- Amblyopia › hysterical (congenital) (ex anopsia) (partial) (suppression)
- Anesthesia, anesthetic › dissociative
- Anesthesia, anesthetic › functional
- Anesthesia, anesthetic › hysterical
R20
Disturbances of skin sensation
Not billable
- Chapter 18
- Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
- Section
- R20-R23
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