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F07.81 ICD-10-CM Code: Postconcussional syndrome

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FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Mental disorders due to known physiological conditions (F01-F09)

F07.81

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Postconcussional syndrome

A collection of symptoms that can occur after a concussion or mild traumatic brain injury, including headaches, dizziness, memory problems, and mood changes.

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
F07Personality and behavioral disorders due to known physiological condition
F07.8Other personality and behavioral disorders due to known physiological condition
F07.81Postconcussional syndrome

Inclusion Terms

Official
  • Postcontusional syndrome (encephalopathy)
  • Post-traumatic brain syndrome, nonpsychotic

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for F07.81 in this effective period.

Related Child Codes

Official
F07.89Other personality and behavioral disorders due to known physiological condition

Includes

Official

ICD-10-CM does not list Includes notes for F07.81 in this effective period.

Excludes 1

Official
  • current concussion (brain) (S06.0X- with seventh character A)
  • postencephalitic syndrome (F07.89)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for F07.81 in this effective period.

Use Additional

Official
  • code to identify associated post-traumatic headache, if applicable (G44.3-)

Code Also

Official
  • , if applicable, sequela of concussion (S06.0X- with seventh character S)

Buddy Documentation Tip

HCC Buddy guidance
Document the history of concussion or head trauma in the medical record
Postconcussional syndrome is typically diagnosed when symptoms persist for weeks to months after the initial injury

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is F07.81 an HCC code?

No. F07.81 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

Coder workflow notes

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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

F07.81 is the ICD-10-CM diagnosis code for postconcussional syndrome. A collection of symptoms that can occur after a concussion or mild traumatic brain injury, including headaches, dizziness, memory problems, and mood changes. F07.81 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).

F07.81 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.

Document the history of concussion or head trauma in the medical record.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for F07.81 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Document the history of concussion or head trauma in the medical record
  • Postconcussional syndrome is typically diagnosed when symptoms persist for weeks to months after the initial injury

Excludes 1, Do NOT code together

  • current concussion (brain) (S06.0X- with seventh character A)
  • postencephalitic syndrome (F07.89)

Use Additional Code

  • code to identify associated post-traumatic headache, if applicable (G44.3-)

Code Also

  • , if applicable, sequela of concussion (S06.0X- with seventh character S)

Child Codes

Code Hierarchy

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