F42.3
BillableHoarding disorder
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F42.3 an HCC code?
No. F42.3 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
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 F42.3
For F42.3 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 F42.3 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F42.3 is the ICD-10-CM diagnosis code for hoarding disorder. Hoarding disorder is characterized by persistent difficulty discarding possessions, regardless of their actual value, resulting in excessive accumulation of items. F42.3 sits in the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99), within the section covering anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders (f40-f48).
F42.3 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.
F42.3 does not map to any HCC under V24 or V28. No ESRD mapping. RxHCC maps to RxHCC 133 at 0.0 weight. Non-risk-adjusting diagnosis. Coders reviewing F42.3 should check whether additional documentation would support a more specific child code in the same hierarchy that does map to a payment HCC — capturing the correct specificity is the highest-leverage RAF improvement available within accurate coding.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for F42.3 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the impact on living spaces and functional impairment caused by hoarding behavior
- •Distinguish from normal collecting by noting the distress or impairment caused by the hoarding
Clinical Significance
Hoarding disorder is an OCD-related condition characterized by persistent difficulty discarding possessions regardless of their actual value, resulting in accumulation that compromises living spaces. This condition poses significant health and safety risks including fire hazards, falls, unsanitary conditions, and inability to use living spaces for intended purposes. It does not carry risk adjustment value.
Documentation Requirements
- ✓Persistent difficulty discarding or parting with possessions regardless of value
- ✓Perceived need to save items and distress associated with discarding them
- ✓Accumulation of possessions that clutter active living areas to the extent that their intended use is compromised
- ✓Clinically significant distress or functional impairment
- ✓Hoarding is not attributable to another medical condition (e.g., brain injury) or another mental disorder
- ✓Assessment of safety hazards (fire risk, fall risk, sanitation concerns)
Commonly Confused Codes
- •F42.2 (Mixed obsessional thoughts and acts) — Classic OCD with washing/checking rituals is different from hoarding; hoarding is now classified as a separate disorder
- •F42.9 (Obsessive-compulsive disorder, unspecified) — Do not use the general OCD code when hoarding is specifically documented
- •F60.5 (Obsessive-compulsive personality disorder) — OCPD may include excessive collecting but the distress pattern differs from hoarding disorder
- •R46.89 (Other symptoms involving appearance and behavior) — Use the specific F42.3 code when hoarding disorder is diagnosed