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F53.1 ICD-10-CM Code: Puerperal psychosis

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

Coding at a Glance

Tabular directives
2 inclusion terms · 3 Excludes1
Risk adjustment
CMS-HCC V28: 1 category · RxHCC V08 category 132

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.

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.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 152 — Psychosis, Except Schizophrenia (supersedes HCC 153, HCC 154, HCC 155)

Other models: RxHCC V08 HCC 132

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for F53.1 in the official ICD-10-CM tabular list, quoted as published.

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

Notes without a marker are published on F53.1 itself; “inherited from” names the category or block whose note applies here.

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Postpartum psychosis
  • Puerperal psychosis, NOS

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).

Source: inherited from F53

Coder workflow for F53.1

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

Before you code F53.1

  1. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with F53.1. 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 F53.1’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.

    ReviewF30.2, F31.2, F31.5, F31.64, F32.3, F33.3

Consider F53.1. 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 F53.1(3 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with F53.1: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareF30.2, F31.2, F31.5, F31.64, F32.3, F33.3

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

Coding decision scenarios

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

Documentation: Both the condition F53.1 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).

ReviewF30.2, F31.2, F31.5, F31.64, F32.3, F33.3

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.

Code Overview

Puerperal psychosis is a billable ICD-10-CM diagnosis code (F53.1).

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 (4)

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

  • Age-restricted: the Medicare Code Editor lists this as a maternity (age 9-64) diagnosis; other ages are presumed incorrect.

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 F53.1 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 1 Excludes1 note: O90.6 — Postpartum mood disturbance.

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

Referenced by 10 Excludes2 notes: O85 — Puerperal sepsis (via F53.-), O85-O92 — Complications predominantly related to the puerperium (O85-O92) (via F53.-), O86 — Other puerperal infections (via F53.-), O87 — Venous complications and hemorrhoids in the puerperium (via F53.-), O88 — Obstetric embolism (via F53.-), O89 — Complications of anesthesia during the puerperium (via F53.-), O90 — Complications of the puerperium, not elsewhere classified (via F53.-), O91 — Infections of breast associated with pregnancy, the puerperium and lactation (via F53.-), O92 — Other disorders of breast and disorders of lactation associated with pregnancy and the puerperium (via F53.-), O99.34 — Other mental disorders complicating pregnancy, childbirth, and the puerperium.

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 885 (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):PRG027 — Complications specified during the puerperium (default); MBD001 — Schizophrenia spectrum and other psychotic 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 (Psychosis, Except Schizophrenia) for risk-adjusted payment.

F22 — Delusional disorders, F23 — Brief psychotic disorder, F24 — Shared psychotic disorder, 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, F30.2 — Manic episode, severe with psychotic symptoms, F31.2 — Bipolar disorder, current episode manic severe with psychotic features, F31.5 — Bipolar disorder, current episode depressed, severe, with psychotic features, F31.64 — Bipolar disorder, current episode mixed, severe, with psychotic features, F32.3 — Major depressive disorder, single episode, severe with psychotic features, F33.3 — Major depressive disorder, recurrent, severe with psychotic symptoms

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, Personality Disorders; Anorexia/Bulimia Nervosa, 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 (Complications specified during the puerperium, Schizophrenia spectrum and other psychotic 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, F53.0 — Postpartum depression, M83.0 — Puerperal osteomalacia, O10.03 — Pre-existing essential hypertension complicating the puerperium, O10.13 — Pre-existing hypertensive heart disease complicating the puerperium, O10.23 — Pre-existing hypertensive chronic kidney disease complicating the puerperium, O10.33 — Pre-existing hypertensive heart and chronic kidney disease complicating the puerperium, O10.43 — Pre-existing secondary hypertension complicating the puerperium, O10.93 — Unspecified pre-existing hypertension complicating the puerperium, O11.5 — Pre-existing hypertension with pre-eclampsia, complicating the puerperium, O12.05 — Gestational edema, complicating the puerperium, O12.15 — Gestational proteinuria, complicating the puerperium, +215 more

Same Index main term, other category

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

F25.9 — Schizoaffective disorder, unspecified (schizoaffective), F28 — Other psychotic disorder not due to a substance or known physiological condition (involutional), F29 — Unspecified psychosis not due to a substance or known physiological condition, F30.2 — Manic episode, severe with psychotic symptoms (mania, manic), F30.8 — Other manic episodes (mania), F31.89 — Other bipolar disorder (mania, manic, recurrent type), F32.3 — Major depressive disorder, single episode, severe with psychotic features (reactive, depressive), F33.3 — Major depressive disorder, recurrent, severe with psychotic symptoms (reactive, depressive, recurrent), F43.0 — Acute stress reaction (exhaustive), F44.9 — Dissociative and conversion disorder, unspecified (hysterical), F84.0 — Autistic disorder (childhood), F84.3 — Other childhood disintegrative disorder (symbiotic), F84.8 — Other pervasive developmental disorders (infantile, atypical), O12.05 — Gestational edema, complicating the puerperium (gestational, edema), O12.15 — Gestational proteinuria, complicating the puerperium (gestational, proteinuria), O12.25 — Gestational edema with proteinuria, complicating the puerperium (gestational, edema, with proteinuria), O15.2 — Eclampsia complicating the puerperium (toxemia), O24.03 — Pre-existing type 1 diabetes mellitus, in the puerperium (diabetes, pre-existing, type 1), O24.13 — Pre-existing type 2 diabetes mellitus, in the puerperium (diabetes, pre-existing, type 2), O24.33 — Unspecified pre-existing diabetes mellitus in the puerperium (diabetes, pre-existing), +125 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Thyroid Stimulating Hormone (TSH)

Contextual Map

Every relationship of F53.1 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 F53.1 with these 9 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

Referenced by Excludes2 notes (10)

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

  • HCC 152 — Psychosis, Except Schizophrenia [CMS-HCC]: “Psychosis, Except Schizophrenia — supersedes HCC 153 (Personality Disorders; Anorexia/Bulimia Nervosa), HCC 154 (Bipolar Disorders without Psychosis), HCC 155 (Major Depression, Moderate or Severe, without Psychosis)”— CMS-HCC V28 · 2026

MS-DRG Grouper

  • DRG 885 — PSYCHOSES[MS-DRG]: “PSYCHOSES (MDC 19)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027

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

  • Pregnancy (single) (uterine), complicated by (care of) (management affected by), psychosis or psychoneurosis (puerperal)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Psychosis, psychotic, postpartum (NOS)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Psychosis, psychotic, puerperal (NOS)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Puerperal, puerperium (complicated by, complications), psychosis (NOS)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes

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
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

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. "F53.1 — Puerperal psychosis." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/f53.1-puerperal-psychosis

Change history

  • FY2019 — October 1, 2018
    Added to the code set
    Puerperal psychosis
    FY2019 changes

Nearest Codes in This Family

Official ICD-10-CM classifications closest to F53.1 in its code family, with their registry titles.

View all codes in the F53 family