F06.0 ICD-10-CM Code: Psychotic disorder with hallucinations due to known physiological condition

F06.0 is the ICD-10-CM diagnosis code for psychotic disorder with hallucinations due to known physiological condition. Hallucinations or false perceptions caused by a known medical condition, such as infection, neurological disease, or metabolic disorder, rather than a primary psychiatric illness. F06.0 sits in the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99), within the section covering mental disorders due to known physiological conditions (f01-f09).

F06.0 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

Clearly document the underlying physiological condition responsible for the psychotic symptoms.