F22 ICD-10-CM Code: Delusional disorders
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Schizophrenia, schizotypal, delusional, and other non-mood psychotic disorders (F20-F29)
F22
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceDelusional disorders
A mental health condition where a person holds one or more non-bizarre delusions (beliefs that could theoretically be true) for at least one month, without other prominent psychotic symptoms.
Buddy Insight
Delusional disorders are characterized by one or more non-bizarre delusions lasting at least one month, without the other prominent psychotic features seen in schizophrenia.
CMS-HCC V28
MappedHCC 152
RAF 0.546
CMS-HCC V24
MappedHCC 59
RAF 0.309
ACA/HHS
00
RAF 0
ESRD/PACE
MappedHCC 59
RAF 0.0
RXHCC
MappedHCC 133
RAF 0.0
Code Trumping
Basket needed
Code Book Path
Inclusion Terms
Official- Delusional dysmorphophobia
- Involutional paranoid state
- Paranoia
- Paranoia querulans
- Paranoid psychosis
Excludes 2
Official- paranoid personality disorder (F60.0)
- paranoid psychosis, psychogenic (F23)
- paranoid reaction (F23)
Related Child Codes
ICD-10-CM does not list child codes under F22 for this display context.
Includes
OfficialICD-10-CM does not list Includes notes for F22 in this effective period.
Excludes 1
Official- mood [affective] disorders with psychotic symptoms (F30.2, F31.2, F31.5, F31.64, F32.3, F33.3)
- paranoid schizophrenia (F20.0)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for F22 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for F22 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for F22 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 F22 an HCC code?
Yes. F22 maps to Delusional and Other Specified Psychotic Disorders under the CMS-HCC V28 risk adjustment model (and Major Depressive, Bipolar, and Paranoid Disorders under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
MEAT Criteria for F22
For F22to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed F22 during that encounter, not just copy-forwarded from a problem list.
What This Code Means
F22 is the ICD-10-CM diagnosis code for delusional disorders. A mental health condition where a person holds one or more non-bizarre delusions (beliefs that could theoretically be true) for at least one month, without other prominent psychotic symptoms. F22 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).
Under the CMS-HCC V28 risk adjustment model, F22 maps to Delusional and Other Specified Psychotic Disorders (HCC 152) with a community, non-dual, aged base RAF weight of 0.546. Under the older CMS-HCC V24 model, F22 maps to Major Depressive, Bipolar, and Paranoid Disorders (HCC 59) with a community, non-dual, aged base RAF weight of 0.309. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
Confirm delusions are non-bizarre and have persisted for at least one month. Because F22 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for F22 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Confirm delusions are non-bizarre and have persisted for at least one month
- •Verify that hallucinations are not prominent and functioning is relatively preserved outside the delusional content
Clinical Significance
Delusional disorders are characterized by one or more non-bizarre delusions lasting at least one month, without the other prominent psychotic features seen in schizophrenia. The delusions may be persecutory, grandiose, jealous, erotomanic, or somatic. Unlike schizophrenia, functioning is relatively preserved outside the delusional content. This distinction is clinically important and affects both treatment approach and risk adjustment, as delusional disorder maps to a different HCC than schizophrenia.
Documentation Requirements
- ✓Documented diagnosis of delusional disorder by a qualified mental health professional
- ✓Description of the specific type of delusion(s) present (persecutory, grandiose, jealous, erotomanic, somatic, mixed)
- ✓Duration of delusions documented as at least one month
- ✓Assessment confirming absence of other prominent psychotic features (hallucinations should be absent or minimal)
- ✓Documentation that overall functioning is relatively intact outside the delusional content
- ✓Treatment plan and medication regimen
Excludes 1, Do NOT code together
Excludes 2, Not included here, may code separately
Commonly Confused Codes
- •F20.0 — Paranoid schizophrenia has broader psychotic features beyond delusions alone
- •F23 — Brief psychotic disorder lasts under one month; delusional disorder requires at least one month
- •F06.2 — Psychotic disorder with delusions due to known physiological condition; rule out medical causes
- •F24 — Shared psychotic disorder involves adoption of delusions from another person
- •F22 vs. F20 — The key distinction is that delusional disorder lacks the disorganized behavior, negative symptoms, and prominent hallucinations of schizophrenia