F21 ICD-10-CM Code: Schizotypal disorder

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for F21 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Coder workflow for F21

MedCoder structured workflow — derived from this code’s own official record

Documentation check

The provider’s diagnostic statement

Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).

Official instructions as workflow

• Excludes2 — not part of F21(2 notes)

  Coding workflow: The conditions named in this note are not included in F21. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

  CompareF84.5, F60.1

  See the official tabular notes · Guidelines I.A.12.b

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Indexed Clinical Terms (10)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

• Disorder (of), personality, schizotypal
• Disorder (of), schizotypal (personality)
• Reaction, schizophrenic, latent
• Schizophrenia, schizophrenic, borderline
• Schizophrenia, schizophrenic, incipient
• Schizophrenia, schizophrenic, latent
• Schizophrenia, schizophrenic, prepsychotic
• Schizophrenia, schizophrenic, prodromal
• Schizophrenia, schizophrenic, pseudoneurotic
• Schizophrenia, schizophrenic, pseudopsychopathic

Don’t confuse F21 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of F21 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

• F84.5— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of Asperger's syndrome adds F84.5; it is not part of this code and both may be reported when both are documented.

  Full comparison: F21 vs F84.5 →

• F60.1— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of schizoid personality disorder adds F60.1; it is not part of this code and both may be reported when both are documented.

  Full comparison: F21 vs F60.1 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Verify Before Coding

• No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name F21 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 3 Excludes1 notes across 2 chapters: F53 — Mental and behavioral disorders associated with the puerperium, not elsewhere classified, R44 — Other symptoms and signs involving general sensations and perceptions, R46 — Symptoms and signs involving appearance and behavior.

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 2 Excludes2 notes: F20 — Schizophrenia, F60.1 — Schizoid personality disorder.

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 1 MS-DRG: DRG 883 (MDC 19).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):MBD001 — Schizophrenia spectrum and other psychotic disorders (default); MBD009 — Personality disorders.

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Personality Disorders; Anorexia/Bulimia Nervosa) for risk-adjusted payment.

F44.0 — Dissociative amnesia, F44.1 — Dissociative fugue, F44.81 — Dissociative identity disorder, F48.1 — Depersonalization-derealization syndrome, F50.00 — Anorexia nervosa, unspecified, F50.010 — Anorexia nervosa, restricting type, mild, F50.011 — Anorexia nervosa, restricting type, moderate, F50.012 — Anorexia nervosa, restricting type, severe, F50.013 — Anorexia nervosa, restricting type, extreme, F50.014 — Anorexia nervosa, restricting type, in remission, F50.019 — Anorexia nervosa, restricting type, unspecified, F50.020 — Anorexia nervosa, binge eating/purging type, mild, F50.021 — Anorexia nervosa, binge eating/purging type, moderate, F50.022 — Anorexia nervosa, binge eating/purging type, severe, F50.023 — Anorexia nervosa, binge eating/purging type, extreme, F50.024 — Anorexia nervosa, binge eating/purging type, in remission, F50.029 — Anorexia nervosa, binge eating/purging type, unspecified, F50.20 — Bulimia nervosa, unspecified, F50.21 — Bulimia nervosa, mild, F50.22 — Bulimia nervosa, moderate, +14 more

Related risk categories

These categories interact through CMS's HCC hierarchy — one can suppress the other's risk-adjustment weight when both are present on a claim.

Schizophrenia, Psychosis, Except Schizophrenia, Bipolar Disorders without Psychosis, Major Depression, Moderate or Severe, without Psychosis

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical categories (Schizophrenia spectrum and other psychotic disorders, Personality disorders).

F19.951 — Other psychoactive substance use, unspecified with psychoactive substance-induced psychotic disorder with hallucinations, F19.959 — Other psychoactive substance use, unspecified with psychoactive substance-induced psychotic disorder, unspecified, F20.0 — Paranoid schizophrenia, F20.1 — Disorganized schizophrenia, F20.2 — Catatonic schizophrenia, F20.3 — Undifferentiated schizophrenia, F20.5 — Residual schizophrenia, F20.81 — Schizophreniform disorder, F20.89 — Other schizophrenia, F20.9 — Schizophrenia, unspecified, F22 — Delusional disorders, F23 — Brief psychotic disorder, F24 — Shared psychotic disorder, F25.0 — Schizoaffective disorder, bipolar type, F25.1 — Schizoaffective disorder, depressive type, F25.8 — Other schizoaffective disorders, F25.9 — Schizoaffective disorder, unspecified, F28 — Other psychotic disorder not due to a substance or known physiological condition, F29 — Unspecified psychosis not due to a substance or known physiological condition, F53 — Mental and behavioral disorders associated with the puerperium, not elsewhere classified, +97 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Reaction”, “Schizophrenia, schizophrenic”; these codes share that main term but sit in a different category of the Tabular List.

E15 — Nondiabetic hypoglycemic coma (hypoglycemic, due to insulin, with coma, nondiabetic), E16.0 — Drug-induced hypoglycemia without coma (hypoglycemic, due to insulin), F03 — Unspecified dementia (paranoid, senile), F20.0 — Paranoid schizophrenia (paranoid), F20.1 — Disorganized schizophrenia (hebephrenic), F20.2 — Catatonic schizophrenia (stupor), F20.3 — Undifferentiated schizophrenia (atypical), F20.5 — Residual schizophrenia (residual), F20.89 — Other schizophrenia (simple), F20.9 — Schizophrenia, unspecified, F22 — Delusional disorders (paranoid, chronic), F23 — Brief psychotic disorder (paranoid), F25.0 — Schizoaffective disorder, bipolar type (cyclic), F28 — Other psychotic disorder not due to a substance or known physiological condition (spectrum and other psychotic disorder, specified NEC), F29 — Unspecified psychosis not due to a substance or known physiological condition (spectrum and other psychotic disorder), F30.8 — Other manic episodes (hypomanic), F31.4 — Bipolar disorder, current episode depressed, severe, without psychotic features (depressive, affective), F32.3 — Major depressive disorder, single episode, severe with psychotic features (depressive, psychotic), F32.89 — Other specified depressive episodes (post-psychotic depression), F32.9 — Major depressive disorder, single episode, unspecified (depressive), +48 more

Contextual Map

Every relationship of F21 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run F21 with these 6 related codes in Claim Check

Hierarchy

• F01-F99 — Chapter 5: Mental, Behavioral and Neurodevelopmental Disorders (F01-F99) (F01-F99)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• F20-F29 — Schizophrenia, schizotypal, delusional, and other non-mood psychotic disorders[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Excludes2

• F60.1 — Schizoid personality disorder[Excludes2]: “schizoid personality disorder (F60.1)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• F84.5 — Asperger's syndrome[Excludes2]: “Asperger's syndrome (F84.5)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Excludes1 notes

• F53 — Mental and behavioral disorders associated with the puerperium, not elsewhere classified[Excludes1]: “psychosis in schizophrenia, schizotypal, delusional, and other psychotic disorders (F20-F29)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R44 — Other symptoms and signs involving general sensations and perceptions[Excludes1]: “hallucinations in schizophrenia, schizotypal and delusional disorders (F20-F29)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R46 — Symptoms and signs involving appearance and behavior[Excludes1]: “appearance and behavior in schizophrenia, schizotypal and delusional disorders (F20-F29)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Excludes2 notes

• F20 — Schizophrenia[Excludes2]: “schizotypal disorder (F21)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• F60.1 — Schizoid personality disorder[Excludes2]: “schizotypal disorder (F21)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Clinical classification (CCSR)

• MBD001 — Schizophrenia spectrum and other psychotic disorders[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
• MBD009 — Personality disorders[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)

Risk adjustment (CMS-HCC)

• HCC 153 — Personality Disorders; Anorexia/Bulimia Nervosa [CMS-HCC]: “Personality Disorders; Anorexia/Bulimia Nervosa — supersedes HCC 154 (Bipolar Disorders without Psychosis), HCC 155 (Major Depression, Moderate or Severe, without Psychosis)”— CMS-HCC V28 · 2026

MS-DRG Grouper

• DRG 883 — DISORDERS OF PERSONALITY AND IMPULSE CONTROL[MS-DRG]: “DISORDERS OF PERSONALITY AND IMPULSE CONTROL (MDC 19)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026

MDC crossing

• MDC 19 — Mental Diseases and Disorders[MDC crossing]: “Mental Diseases and Disorders — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”— CMS MS-DRG Definitions Manual · FY2026

Index entries (10)

• Disorder (of), personality, schizotypal[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Disorder (of), schizotypal (personality)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Reaction, schizophrenic, latent[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Schizophrenia, schizophrenic, borderline[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Schizophrenia, schizophrenic, incipient[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Schizophrenia, schizophrenic, latent[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Schizophrenia, schizophrenic, prepsychotic[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Schizophrenia, schizophrenic, prodromal[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• and 2 more

Change history

• FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data

CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page

Claim edits Official source data

CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page

Inpatient payment groups Official source data

CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page

Risk adjustment Official source data

2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release Release, file and checksum · Publisher’s page

Change history and date-of-service validity Official source data

CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page

Comparisons, relationships and the contextual map MedCoder structured relationship

Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears

Summary and FAQ answers MedCoder explanation

Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates