F20 ICD-10-CM Code: Schizophrenia
HCC Buddy Code Card
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FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Schizophrenia, schizotypal, delusional, and other non-mood psychotic disorders (F20-F29)
F20
Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidanceSchizophrenia
Schizophrenia
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
Code Trumping
Basket needed
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for F20 in this effective period.
Excludes 2
Official- schizophrenic reaction in:
- alcoholism (F10.15-, F10.25-, F10.95-)
- brain disease (F06.2)
- epilepsy (F06.2)
- psychoactive drug use (F11-F19 with .15. .25, .95)
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for F20 in this effective period.
Excludes 1
Official- brief psychotic disorder (F23)
- cyclic schizophrenia (F25.0)
- mood [affective] disorders with psychotic symptoms (F30.2, F31.2, F31.5, F31.64, F32.3, F33.3)
- schizoaffective disorder (F25.-)
- schizophrenic reaction NOS (F23)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for F20 in this effective period.
Use Additional
Official- code, if applicable, to identify:
- other specified cognitive deficit (R41.84-)
Code Also
OfficialICD-10-CM does not list Code Also instructions for F20 in this effective period.
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.
What This Code Means
F20 is the ICD-10-CM diagnosis code for schizophrenia. F20 sits in the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99), within the section covering schizophrenia, schizotypal, delusional, and other non-mood psychotic disorders (f20-f29).
Header codes like F20 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at F20's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for F20 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Excludes 1, Do NOT code together
Excludes 2, Not included here, may code separately
Use Additional Code
- code, if applicable, to identify:
- other specified cognitive deficit (R41.84-)