F22 vs F45.22

F22 (Delusional disorders) compared with F45.22 (Body dysmorphic disorder), from the official CMS tabular data.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Summary

These codes can be reported together when both conditions are documented, because F45.22 lists F22 under Excludes2, which marks them as distinct conditions.

Official rule

What is different?

The conditions named.F22 is “Delusional disorders”; F45.22 is “Body dysmorphic disorder”.

Registry fact

Can these codes be reported together?

Yes, when both are documented.F45.22 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 Excludes2 relationship?

Yes.F45.22’s tabular entry: “delusional dysmorphophobia (F22)”. The note covers F22.

Official ruleGuide: Excludes1 vs Excludes2

Nothing found in 4 other checks; 1 check does not apply

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 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

F45.22

Body dysmorphic disorder

↔

F22

Delusional disorders

What we found

Yes, when both are documented.F45.22 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 Excludes2 Check 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 FY2027

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

Similar descriptions do not make codes interchangeable. The documentation and the official instructions decide which code applies.

F22ICD-10-CM · FY2027

F45.22ICD-10-CM · FY2027

Official descriptionDiffers

F22

Delusional disorders

F45.22

Body dysmorphic disorder

StatusSame for both

Billable

Excludes1Differs

F22

mood [affective] disorders with psychotic symptoms (F30.2, F31.2, F31.5, F31.64, F32.3, F33.3)
paranoid schizophrenia (F20.0)

F45.22

None at this code

Excludes2Differs

F22

paranoid personality disorder (F60.0)
paranoid psychosis, psychogenic (F23)
paranoid reaction (F23)

F45.22

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)

CategoryDiffers

F22

Is itself a category

F45.22

F45 Somatoform disorders

ChapterSame for both

F01-F99 — Mental, Behavioral and Neurodevelopmental Disorders (F01-F99)

IncludesDiffers

F22

Delusional dysmorphophobia
Involutional paranoid state
Paranoia
Paranoia querulans
Paranoid psychosis
Paranoid state
Paraphrenia (late)
Sensitiver Beziehungswahn

F45.22

Bigorexia
Dysmorphophobia (nondelusional)
Muscle dysmorphia
Nosophobia

No Code first, Use additional code, Code also and 7th character note at either code.

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. In a row that differs, each code’s own notes are listed under it, and the notes every code shares are listed once beneath them.

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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