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F42.4 ICD-10-CM Code: Excoriation (skin-picking) disorder

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
2 Excludes1 · 3 Excludes2
Risk adjustment
RxHCC V08 category 133

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 882 — NEUROSES EXCEPT DEPRESSIVE (MDC 19)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for F42.4 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on F42.4 itself; “inherited from” names the category or block whose note applies here.

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Source: inherited from F42

Coder workflow for F42.4

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

Before you code F42.4

  1. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with F42.4. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support a condition named in F42.4’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewL98.1, F98.8

Consider F42.4. Then confirm the code is valid for the date of service in the Verify section.

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

  • Excludes1 — check before selecting F42.4(2 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with F42.4: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareL98.1, F98.8

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

  • Excludes2 — not part of F42.4(3 notes)

    Coding workflow: The conditions named in this note are not included in F42.4. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareF60.5, F32, F33, F20

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

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition F42.4 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewL98.1, F98.8

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.

Coding context

The comparisons, hierarchy, index entries, guidelines, relationships, risk-adjustment and coverage context a coder commonly needs. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Don’t confuse F42.4 with…

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

The codes most likely to be picked instead of F42.4 — 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.

  • L98.1— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of factitial dermatitis moves the case to L98.1; the two are not reported together unless documented as unrelated.

    Full comparison: F42.4 vs L98.1 →

  • F98.8— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of other specified behavioral and emotional disorders with onset usually occurring in early childhood and adolescence moves the case to F98.8; the two are not reported together unless documented as unrelated.

    Full comparison: F42.4 vs F98.8 →

  • F42.9— Specificity relationship (Review)

    Overlapping diagnoses in the same category.

    Overlapping codes in the same category — the documentation decides which is the more specific fit.

    What moves you there: A record that documents no more than “Obsessive-compulsive disorder, unspecified” takes F42.9; specificity in the record moves it back here.

    Full comparison: F42.4 vs F42.9 →

  • F60.5— 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 obsessive-compulsive personality (disorder) adds F60.5; it is not part of this code and both may be reported when both are documented.

    Full comparison: F42.4 vs F60.5 →

  • F32— 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 obsessive-compulsive symptoms occurring in depression adds F32; it is not part of this code and both may be reported when both are documented.

    Full comparison: F42.4 vs F32 →

  • F33— 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 obsessive-compulsive symptoms occurring in depression adds F33; it is not part of this code and both may be reported when both are documented.

    Full comparison: F42.4 vs F33 →

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.

Code Overview

Excoriation (skin-picking) disorder is a billable ICD-10-CM diagnosis code (F42.4).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Indexed Clinical Terms (2)

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.

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 F42.4 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 2 Excludes1 notes across 2 chapters: L98.1 — Factitial dermatitis, R46.81 — Obsessive-compulsive behavior (via F42.-).

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

Referenced by 4 Excludes2 notes: F60.5 — Obsessive-compulsive personality disorder (via F42.-), F93.0 — Separation anxiety disorder of childhood (via F42.-), F98 — Other behavioral and emotional disorders with onset usually occurring in childhood and adolescence (via F42.-), F98.4 — Stereotyped movement disorders (via F42.-).

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

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 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 882 (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):MBD006 — Obsessive-compulsive and related disorders (default).

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 clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Obsessive-compulsive and related disorders).

F42 — Obsessive-compulsive disorder, F42.2 — Mixed obsessional thoughts and acts, F42.3 — Hoarding disorder, F42.8 — Other obsessive-compulsive disorder, F42.9 — Obsessive-compulsive disorder, unspecified, F45.22 — Body dysmorphic disorder, F63.3 — Trichotillomania

Same Index main term, other category

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

L98.1 — Factitial dermatitis

Contextual Map

Every relationship of F42.4 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 F42.4 with these 7 related codes in Claim Check

Hierarchy

Excludes1

Referenced by Excludes1 notes

Referenced by Excludes2 notes

Clinical classification (CCSR)

MS-DRG Grouper

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 · FY2027

Index entries

  • Disorder (of), skin, picking[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Excoriation (traumatic), skin picking disorder[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027

Nearest codes

Change history

Deep reference

Published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

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 FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 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 — v44 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.

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 20, 2026 · All releases and sources

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

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "F42.4 — Excoriation (skin-picking) disorder." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/f42.4-excoriation-skin-picking-disorder

Change history

  • FY2017 — October 1, 2016
    Added to the code set
    Excoriation (skin-picking) disorder
    FY2017 changes

Nearest Codes in This Family

Official ICD-10-CM classifications closest to F42.4 in its code family, with their registry titles.

View all codes in the F42 family