What is ICD-10 code F34.81?

F34.81 is the ICD-10-CM diagnosis code for Disruptive mood dysregulation disorder. It belongs to the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99). F34.81 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. F34.81 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. F34.81 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. F34.81 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does F34.81 map to under V28?

F34.81 has no payable CMS-HCC V28 mapping in the final FY2026 CMS file.

What RAF reference is published for F34.81?

F34.81 has no V28 reference coefficient because the final FY2026 source verifies no payable V28 mapping.

What is the V28 vs V24 difference for F34.81?

F34.81 has verified no payable V28 mapping in the final FY2026 source. Select a historical effective period before making any V24 comparison.

What documentation supports F34.81?

Ensure documentation specifies the age of onset (typically before age 10) and frequency of mood episodes to support medical necessity Do not code this diagnosis in patients over age 18, as DMDD is a childhood disorder; verify patient age before assignment F34.81 is not a CMS-HCC V28 payment code in the verified current source, so MEAT is not the payment hook. Documentation still has to support the diagnosis if you report it.

2026 ICD-10-CM F34.81: Disruptive mood dysregulation

F34.81 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools

ICD-10-CM Code View

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Code lookupF34.81Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Mood [affective] disorders (F30-F39)

F34.81

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

Disruptive mood dysregulation disorder

A condition where children have severe difficulty controlling their emotions, experiencing frequent angry outbursts and irritability that are much more intense than typical childhood mood swings. This disorder typically appears before age 10 and significantly impacts the child's ability to function at home, school, and with peers.

Buddy Insight

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

N/A

—

Not risk-adjusted for this model/period.

Not mapped

RXHCC

Mapped

HCC 133

Anxiety and Other Psychiatric...

Code-level coefficient reference

Code Book Path

Official

F34Persistent mood [affective] disorders

F34.8Other persistent mood [affective] disorders

F34.81Disruptive mood dysregulation disorder

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for F34.81 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for F34.81 in this effective period.

Related Child Codes

Official

F34.89Other specified persistent mood disorders

Includes

Official

ICD-10-CM does not list Includes notes for F34.81 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for F34.81 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for F34.81 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for F34.81 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for F34.81 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Age of onset documented as before age 10 years

Patient must be between ages 6 and 18 at time of diagnosis

Severe temper outbursts occurring 3 or more times per week

Persistent irritable or angry mood between outbursts, present most of the day, nearly every day

MEAT Support

HCC Buddy guidance

Age of onset documented as before age 10 years

Patient must be between ages 6 and 18 at time of diagnosis

Severe temper outbursts occurring 3 or more times per week

Persistent irritable or angry mood between outbursts, present most of the day, nearly every day

Audit Caution

HCC Buddy guidance

Assigning DMDD to patients over age 18 — this is exclusively a childhood/adolescent diagnosis

Coding DMDD simultaneously with oppositional defiant disorder (F91.3) or intermittent explosive disorder (F63.81) — DMDD cannot be diagnosed concurrently with either

Coding both DMDD and bipolar disorder — these diagnoses are mutually exclusive per DSM-5 guidelines

Failing to verify that outburst frequency meets the 3+ per week threshold documented in the record

Common Mistakes

HCC Buddy guidance

F31.9 (Bipolar disorder, unspecified) — DMDD lacks distinct manic episodes; bipolar requires episodic mania/hypomania whereas DMDD has chronic irritability

F91.3 (Oppositional defiant disorder) — ODD involves defiant/vindictive behavior patterns; DMDD requires severe temper outbursts disproportionate to provocation plus persistent irritability

F34.1 (Dysthymic disorder) — Dysthymia is persistent depressive mood without the severe outburst component of DMDD

F90.2 (Attention-deficit hyperactivity disorder, combined type) — ADHD involves inattention/hyperactivity; can be comorbid but distinct from DMDD mood dysregulation

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is F34.81 an HCC code?

F34.81 is not in the CMS-HCC V28 or V24 community payment model. F34.81 has a separate mapping under the CMS-HCC ESRD model (HCC 59 (Major Depressive/Bipolar/and Paranoid Disorders)) and the Part D RxHCC model (HCC 133 (Anxiety and Other Psychiatric Disorders)); the applicable result needs member context. F34.81 also appears in the HHS-HCC commercial risk model (HCC 088 (HHS-HCC 088 adult, RAF varies by metal level)), where the result depends on member context and is not a Medicare Advantage payment mapping.

Code: F34.81
Description: Disruptive mood dysregulation disorder
HCC (V28): No CMS-HCC V28 mapping
RAF reference coefficient: —
Billable: Yes
Payment year: 2026

HCC Category Mapping

RxHCCHCC 133, Anxiety and Other Psychiatric Disorders

Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work F34.81 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT Criteria for F34.81

For F34.81 to 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 F34.81 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

F34.81 is the ICD-10-CM diagnosis code for disruptive mood dysregulation disorder. A condition where children have severe difficulty controlling their emotions, experiencing frequent angry outbursts and irritability that are much more intense than typical childhood mood swings. This disorder typically appears before age 10 and significantly impacts the child's ability to function at home, school, and with peers. F34.81 sits in the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99), within the section covering mood [affective] disorders (f30-f39).

F34.81 has no mapping under the CMS-HCC V28 or V24 community payment models. F34.81 has a separate mapping under the CMS-HCC ESRD model (HCC 59 (Major Depressive/Bipolar/and Paranoid Disorders)) and the Part D RxHCC model (HCC 133 (Anxiety and Other Psychiatric Disorders)); the applicable result needs member context. F34.81 also appears in the HHS-HCC commercial risk model (HCC 088 (HHS-HCC 088 adult, RAF varies by metal level)), where the result depends on member context and is not a Medicare Advantage payment mapping. Do not assign V28 risk adjustment value from this page; verify the applicable model and payment year before using this code for risk adjustment.

Ensure documentation specifies the age of onset (typically before age 10) and frequency of mood episodes to support medical necessity.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for F34.81 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Ensure documentation specifies the age of onset (typically before age 10) and frequency of mood episodes to support medical necessity
•Do not code this diagnosis in patients over age 18, as DMDD is a childhood disorder; verify patient age before assignment

Clinical Significance

Disruptive mood dysregulation disorder (DMDD) is a childhood-onset condition characterized by severe, recurrent temper outbursts grossly out of proportion to the situation, with persistent irritable or angry mood between outbursts. Accurate capture is important as DMDD was introduced in DSM-5 specifically to reduce overdiagnosis of bipolar disorder in children.

Documentation Requirements

✓Age of onset documented as before age 10 years
✓Patient must be between ages 6 and 18 at time of diagnosis
✓Severe temper outbursts occurring 3 or more times per week
✓Persistent irritable or angry mood between outbursts, present most of the day, nearly every day
✓Symptoms present for at least 12 months without a symptom-free period of 3 or more consecutive months
✓Symptoms observed in at least two of three settings (home, school, peers)
✓Documentation that symptoms are not better explained by another mental disorder (bipolar, oppositional defiant disorder, autism spectrum disorder)
✓Current treatment plan including behavioral interventions and/or pharmacotherapy

Commonly Confused Codes

•F31.9 (Bipolar disorder, unspecified): DMDD lacks distinct manic episodes; bipolar requires episodic mania/hypomania whereas DMDD has chronic irritability
•F91.3 (Oppositional defiant disorder): ODD involves defiant/vindictive behavior patterns; DMDD requires severe temper outbursts disproportionate to provocation plus persistent irritability
•F34.1 (Dysthymic disorder): Dysthymia is persistent depressive mood without the severe outburst component of DMDD
•F90.2 (Attention-deficit hyperactivity disorder, combined type): ADHD involves inattention/hyperactivity; can be comorbid but distinct from DMDD mood dysregulation

Child Codes

F34.81Disruptive mood dysregulation disorder

F34.89Other specified persistent mood disorders

Code Hierarchy

└F34Persistent mood [affective] disorders └F34.8Other persistent mood [affective] disorders └F34.81Disruptive mood dysregulation disorder

└F34.81Disruptive mood dysregulation disorder

HCC Buddy Code Card

F34.81

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HCC Category Mapping

MEAT Criteria for F34.81

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What This Code Means

Coding Tips

Clinical Significance

Documentation Requirements

Commonly Confused Codes

Child Codes

Code Hierarchy

F34.81 code history

Work F34.81 in HCC Buddy

F34.81 ICD-10-CM Code: Disruptive mood dysregulation disorder

HCC Buddy Code Card

F34.81

Is F34.81 an HCC code?

HCC Category Mapping

MEAT Criteria for F34.81

Get the V28 mapping + MEAT cheat sheet

What This Code Means

Coding Tips

Clinical Significance

Documentation Requirements

Commonly Confused Codes

Child Codes

Code Hierarchy

F34.81 code history

Work F34.81 in HCC Buddy