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F54 ICD-10-CM Code: Psychological and behavioral factors associated with disorders or diseases classified elsewhere

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

Coding at a Glance

Tabular directives
1 inclusion term · 1 Excludes2 · 7 code-first instructions

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 v43, Appendix B.

  • MS-DRG 884 — ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY (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 F54 in the official ICD-10-CM tabular list, quoted as published.

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Psychological factors affecting physical conditions

Excludes2 — Not Included Here

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

Code First

Underlying conditions that must be sequenced before this code.

  • the associated physical disorder, such as:
  • asthma (J45.-)
  • dermatitis (L23-L25)
  • gastric ulcer (K25.-)
  • mucous colitis (K58.-)
  • ulcerative colitis (K51.-)
  • urticaria (L50.-)

Coder workflow for F54

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

Before you code F54

  1. F54’s title joins a condition with an associated condition or complication. Confirm each component is documented. Where the classification presumes the link through the “with” convention, only a provider statement that the conditions are unrelated defeats it. A combination code is assigned only when it fully identifies the documented conditions; a required second code for the stage, type or manifestation is still reported when the notes ask for it (Guidelines I.B.9, I.A.15).

    Guide: Combination codes →

Choose the right path

  1. Is the underlying (etiologic) condition the Code First note names documented?
    Yes → Sequence the underlying condition first, then F54.
    No → Continue; do not add an underlying condition the record does not document.

    ReviewJ45, K25, K58, K51, L50

Consider F54. 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).
The associated condition or complication
Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).
The underlying (etiologic) condition
Named in the Code First note; sequenced before this code when documented (Guidelines I.A.13).

Official instructions as workflow

  • Excludes2 — not part of F54(1 note)

    Coding workflow: The conditions named in this note are not included in F54. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareG44.2

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

  • Code First — sequencing check(7 notes)

    Coding workflow: Check whether the underlying or etiologic condition the note names is documented. When it is, sequence it before F54. Do not add an underlying condition the record does not document.

    ReviewJ45, K25, K58, K51, L50

    See the official tabular notes · Guidelines I.A.13

Coding decision scenarios

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

Documentation: Only one of the components this code’s title joins is documented.

Coding question: Is F54 supported?

Path: Review the code for the documented component on its own.

Reason: A combination code is assigned only when it fully identifies the documented conditions; otherwise the documented component takes its own code (Guidelines I.B.9).

Documentation: The underlying condition the Code First note names is documented alongside this condition.

Coding question: How are the two sequenced?

Path: Review the Code First note.

Reason: The underlying condition is sequenced first and the manifestation follows (Guidelines I.A.13).

ReviewJ45, K25, K58, K51, L50

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

Psychological and behavioral factors associated with disorders or diseases classified elsewhere is a billable ICD-10-CM diagnosis code (F54).

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 (29)

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

  • Principal-diagnosis restriction. This is a manifestation code: the Medicare Code Editor requires the underlying condition (etiology) to be sequenced first, with this code reported after it.

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 F54 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 Excludes2 note: F45 — Somatoform disorders.

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.

Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.

Named in the grouper logic of 1 MS-DRG: DRG 884 (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):MBD013 — Miscellaneous mental and behavioral disorders/conditions.

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

Related Codes

Principal diagnosis restriction (Medicare Code Editor)

Manifestation code — the underlying condition is sequenced first.

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Miscellaneous mental and behavioral disorders/conditions).

F52.1 — Sexual aversion disorder, F52.21 — Male erectile disorder, F52.22 — Female sexual arousal disorder, F52.31 — Female orgasmic disorder, F52.32 — Male orgasmic disorder, F52.4 — Premature ejaculation, F52.5 — Vaginismus not due to a substance or known physiological condition, F52.6 — Dyspareunia not due to a substance or known physiological condition, F52.8 — Other sexual dysfunction not due to a substance or known physiological condition, F52.9 — Unspecified sexual dysfunction not due to a substance or known physiological condition, F55.0 — Abuse of antacids, F55.1 — Abuse of herbal or folk remedies, F55.2 — Abuse of laxatives, F55.3 — Abuse of steroids or hormones, F55.4 — Abuse of vitamins, F55.8 — Abuse of other non-psychoactive substances, F59 — Unspecified behavioral syndromes associated with physiological disturbances and physical factors, F63.0 — Pathological gambling, F64.0 — Transsexualism, F64.1 — Dual role transvestism, +32 more

Same Index main term, other category

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

F15.222 — Other stimulant dependence with intoxication with perceptual disturbance (perceptual due to, amphetamine intoxication, in, dependence), F15.922 — Other stimulant use, unspecified with intoxication with perceptual disturbance (perceptual due to, amphetamine intoxication), F16.122 — Hallucinogen abuse with intoxication with perceptual disturbance (perceptual due to, phencyclidine intoxication), F40.10 — Social phobia, unspecified (emotions specific to childhood and adolescence, with, shyness), F43.0 — Acute stress reaction (situational, acute), F44.4 — Conversion disorder with motor symptom or deficit (psychomotor), F44.6 — Conversion disorder with sensory symptom or deficit (sensation NEC, hysterical), F45.8 — Other somatoform disorders (hysterical), F45.9 — Somatoform disorder, unspecified (psychogenic), F51.9 — Sleep disorder not due to a substance or known physiological condition, unspecified (sleep, nonorganic origin), F60.2 — Antisocial personality disorder (sociopathic), F60.9 — Personality disorder, unspecified (personality), F63.9 — Impulse disorder, unspecified (conduct, compulsive), F80.9 — Developmental disorder of speech and language, unspecified (speech, developmental), F91.1 — Conduct disorder, childhood-onset type (conduct, unsocialized), F91.2 — Conduct disorder, adolescent-onset type (conduct, socialized), F91.3 — Oppositional defiant disorder (emotions specific to childhood and adolescence, with, oppositional disorder), F91.8 — Other conduct disorders (conduct, specified NEC), F91.9 — Conduct disorder, unspecified (conduct), F93.8 — Other childhood emotional disorders (emotions specific to childhood and adolescence, mixed), +387 more

Contextual Map

Every relationship of F54 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 F54 with these 10 related codes in Claim Check

Hierarchy

Excludes2

Code First

Referenced by Excludes2 notes

  • F45 — Somatoform disorders[Excludes2]: “psychological or behavioral factors associated with disorders or diseases classified elsewhere (F54)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

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 · FY2026

Index entries (29)

  • Asthma, asthmatic (bronchial) (catarrh) (spasmodic), psychogenic[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Colic (bilious) (infantile) (intestinal) (recurrent) (spasmodic), mucous, psychogenic[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Colitis (acute) (catarrhal) (chronic) (noninfective) (hemorrhagic), membranous, psychogenic[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Colitis (acute) (catarrhal) (chronic) (noninfective) (hemorrhagic), mucous, psychogenic[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Colitis (acute) (catarrhal) (chronic) (noninfective) (hemorrhagic), spastic, psychogenic[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Colitis (acute) (catarrhal) (chronic) (noninfective) (hemorrhagic), ulcerative (chronic), psychogenic[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Dermatitis (eczematous), artefacta, psychogenic[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Dermatitis (eczematous), atopic, psychogenic[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • and 21 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
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

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Psychological and behavioral factors associated with disorders or diseases classified elsewhere

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.