F20.2
BillableCatatonic schizophrenia
HCC Category Mapping
V28HCC 151 — Schizophrenia
0.244V24HCC 57 — Schizophrenia
0.508ESRDHCC 57 — Schizophrenia
0.000RxHCCHCC 130 — Schizophrenia
0.000What This Code Means
A type of schizophrenia where a person exhibits unusual motor behaviors, such as remaining motionless for extended periods, excessive purposeless movement, or mimicking others' movements.
Coding Tips
- •Document specific catatonic features such as waxy flexibility, mutism, or posturing
- •Ensure catatonic symptoms are present and are not attributed to another medical condition or substance use
Clinical Significance
Catatonic schizophrenia is characterized by prominent psychomotor disturbances including stupor, rigidity, waxy flexibility, negativism, mutism, or excessive purposeless motor activity. This is a potentially life-threatening presentation requiring urgent medical attention, as patients may become unable to eat, drink, or care for themselves. The severe nature of catatonic episodes, which may require benzodiazepines or electroconvulsive therapy, justifies the high HCC weight.
Documentation Requirements
- ✓Diagnosis of schizophrenia with catatonic features by a qualified mental health professional
- ✓Documentation of specific catatonic symptoms (stupor, catalepsy, waxy flexibility, mutism, negativism, posturing, mannerisms, stereotypy, agitation, grimacing, echolalia, echopraxia)
- ✓At least three catatonic features should be documented per diagnostic criteria
- ✓Assessment of nutritional status and ability to maintain hydration during catatonic episodes
- ✓Current treatment approach (benzodiazepines, electroconvulsive therapy, antipsychotics)
- ✓Monitoring plan for medical complications (dehydration, deep vein thrombosis, aspiration)
Excludes 1 — Do NOT code together
- catatonic stupor (R40.1)
Commonly Confused Codes
F06.1 — Catatonic disorder due to known physiological condition; use when catatonia has a medical cause (e.g., autoimmune encephalitis)F20.0 — Paranoid schizophrenia lacks the motor features characteristic of catatonic schizophreniaF20.1 — Disorganized schizophrenia has behavioral disorganization but not the specific motor features of catatoniaR40.1 — Stupor as a symptom code should not be used when catatonic schizophrenia is diagnosedF31.2 — Bipolar disorder with catatonic features may present similarly but involves mood episodes