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F22 vs F45.20

F22 (Delusional disorders) compared with F45.20 (Hypochondriacal disorder, unspecified), from the official CMS tabular data.

Summary

These codes can be reported together when both conditions are documented, because F45.20 lists F22 under Excludes2, which marks them as distinct conditions.

Official rule
What is different?

The conditions named.F22 is “Delusional disorders”; F45.20 is “Hypochondriacal disorder, unspecified”.

Registry fact

Can these codes be reported together?

Yes, when both are documented.F45.20 lists F22 under Excludes2: “delusional dysmorphophobia (F22)”. Excludes2 marks distinct conditions that may both be reported when both are documented.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes1 relationship?

None.Neither entry carries an Excludes1 note that names the other code. F22 carries 2 Excludes1 notes covering other codes; the side-by-side table quotes them.

Official rule

Is there an Excludes2 relationship?

Yes.F45.20’s tabular entry: “delusional dysmorphophobia (F22)”. The note covers F22.

Official ruleGuide: Excludes1 vs Excludes2

Is one more specific?

Not comparable.The codes sit in different categories; specificity is only comparable within one category.

Is one a parent or header code?

No.Both are billable codes, and neither contains the other.

Registry fact

Are there sequencing instructions?

None.Neither entry carries a Code First or Use Additional Code note that names the other.

Official rule

Are there other coding relationships?

None found.No laterality, encounter-phase, Table of Neoplasms, Table of Drugs and Chemicals, or history-versus-active-disease relationship links these codes.

MedCoder-derived

Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule. How to read the labels

Can these codes be reported together?

Informational

Excludes2 relationship

F45.20
Hypochondriacal disorder, unspecified
↔
F22
Delusional disorders

What we found

Yes, when both are documented.F45.20 carries an Excludes2 note covering F22: “delusional dysmorphophobia (F22)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

What to review

Report both only when the documentation supports both conditions; otherwise report the one documented.

Guide: Excludes1 vs Excludes2Check these on a claim

Why it matters

An Excludes2 note means the excluded condition is not part of the code above it, but a patient can have both. Report both when both are documented.

Source / rule

CMS ICD-10-CM tabular instructional notes

Official guidance behind these answers

  • Section I.A.12.b — Excludes2 · applies to: Excludes2

    A type 2 Excludes note represents “Not included here.” An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.

    ICD-10-CM Official Guidelines FY2026

Quoted from the ICD-10-CM Official Guidelines for Coding and Reporting in effect for the release shown. The tabular notes above are the code-level instruction; these sections are the convention that says how such a note is applied. Source document (CMS PDF) · Release and checksum

Side by side

F22Delusional disordersF45.20Hypochondriacal disorder, unspecified
Billing statusBillableBillable
ClassificationF01-F99 — Mental, Behavioral and Neurodevelopmental Disorders (F01-F99)F01-F99 — Mental, Behavioral and Neurodevelopmental Disorders (F01-F99)
DefinitionDelusional disorders is a billable ICD-10-CM diagnosis code (F22).Hypochondriacal disorder, unspecified is a billable ICD-10-CM diagnosis code (F45.20).
Includes
Delusional dysmorphophobia
Involutional paranoid state
Paranoia
Paranoia querulans
—
Excludes1
mood [affective] disorders with psychotic symptoms (F30.2, F31.2, F31.5, F31.64, F32.3, F33.3)
paranoid schizophrenia (F20.0)
—
Excludes2
paranoid personality disorder (F60.0)
paranoid psychosis, psychogenic (F23)
paranoid reaction (F23)
delusional dysmorphophobia (F22)
fixed delusions about bodily functions or shape (F22)
dissociative and conversion disorders (F44.-)
factitious disorders (F68.1-, F68.A)
hair-plucking (F63.3)
lalling (F80.0)
lisping (F80.0)
malingering [conscious simulation] (Z76.5)
nail-biting (F98.8)
psychological or behavioral factors associated with disorders or diseases classified elsewhere (F54)
sexual dysfunction, not due to a substance or known physiological condition (F52.-)
thumb-sucking (F98.8)
tic disorders (in childhood and adolescence) (F95.-)
Tourette's syndrome (F95.2)
trichotillomania (F63.3)

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on.

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Derived from the official CMS ICD-10-CM tabular data (FY2027). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources