What is ICD-10 code F43.11?

F43.11 is the ICD-10-CM diagnosis code for Post-traumatic stress disorder, acute. Post-traumatic stress disorder that develops shortly after a traumatic event and typically lasts between 3 days and 3 months. It belongs to the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99). F43.11 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. F43.11 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. F43.11 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. F43.11 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.

What is the V28 vs V24 difference for F43.11?

F43.11 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither community model rewards F43.11 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's V28/V24 community RAF score in either version. It does, however, map under the Part D RxHCC model (Personality Disorders, Anxiety, and Other Specified Mental Disorders), which affects the ESRD and/or Part D (RxHCC) risk scores. Coders should check whether provider documentation supports a more specific child code that does map to a community payment HCC.

What should coders know when reporting F43.11?

Document the onset date relative to the traumatic event to confirm acute timing Note when symptoms began and their duration to differentiate from chronic PTSD

2026 ICD-10-CM F43.11: Post-traumatic stress disorder, acute

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupF43.11Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders (F40-F48)

F43.11

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

Post-traumatic stress disorder, acute

Post-traumatic stress disorder that develops shortly after a traumatic event and typically lasts between 3 days and 3 months.

Buddy Insight

Post-traumatic stress disorder, acute, specifies that PTSD symptoms have been present for less than 3 months.

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

N/A

—

Not risk-adjusted for this model/period.

Not mapped

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

Personality Disorders, Anxiet...

RAF 0.035

Code Book Path

Official

F43Reaction to severe stress, and adjustment disorders

F43.1Post-traumatic stress disorder (PTSD)

F43.11Post-traumatic stress disorder, acute

Inclusion Terms

Official

Traumatic neurosis

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for F43.11 in this effective period.

Related Child Codes

Official

F43.10Post-traumatic stress disorder, unspecified

F43.12Post-traumatic stress disorder, chronic

Includes

Official

ICD-10-CM does not list Includes notes for F43.11 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for F43.11 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for F43.11 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for F43.11 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for F43.11 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documented exposure to a qualifying traumatic event

All four PTSD symptom clusters present: re-experiencing, avoidance, negative cognitions/mood, hyperarousal

Duration of symptoms greater than 1 month but less than 3 months

Onset related to identified traumatic event

MEAT Support

HCC Buddy guidance

Documented exposure to a qualifying traumatic event

All four PTSD symptom clusters present: re-experiencing, avoidance, negative cognitions/mood, hyperarousal

Duration of symptoms greater than 1 month but less than 3 months

Onset related to identified traumatic event

Audit Caution

HCC Buddy guidance

Confusing acute PTSD (F43.11) with acute stress disorder (F43.0) — different conditions with different timeframes

Using F43.11 when symptoms have exceeded the 3-month threshold — transition to F43.12 (chronic) at that point

Not updating the code from acute to chronic at subsequent encounters when symptoms persist beyond 3 months

Coding acute PTSD within the first month of trauma when acute stress disorder (F43.0) is the correct diagnosis

Common Mistakes

HCC Buddy guidance

F43.12 (Post-traumatic stress disorder, chronic) — Chronic PTSD requires symptoms lasting 3+ months; acute is less than 3 months

F43.0 (Acute stress disorder) — Acute stress disorder is within 3 days to 1 month; acute PTSD is 1-3 months after trauma

F43.10 (Post-traumatic stress disorder, unspecified) — Use F43.11 when documentation specifies the acute timeframe

F43.22 (Adjustment disorder with anxiety) — Adjustment disorder has less severe symptoms and may not involve a qualifying trauma

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 F43.11 an HCC code?

F43.11 is not in the CMS-HCC V28 or V24 community payment model, but it does map to Personality Disorders, Anxiety, and Other Specified Mental Disorders under the Part D RxHCC model.

Code: F43.11
Description: Post-traumatic stress disorder, acute
HCC (V28): No CMS-HCC V28 mapping
RAF: —
Billable: Yes
Payment year: 2026

HCC Category Mapping

RxHCCHCC 133, Personality Disorders, Anxiety, and Other Specified Mental Disorders

0.035

Each model's RAF is its CMS base weight for that model's standard population, so 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 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.

Work F43.11 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for F43.11

For F43.11 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 F43.11 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

F43.11 is the ICD-10-CM diagnosis code for post-traumatic stress disorder, acute. Post-traumatic stress disorder that develops shortly after a traumatic event and typically lasts between 3 days and 3 months. F43.11 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).

F43.11 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.

This code does not map to a CMS-HCC V28 payment category. Capture depends on documentation that supports the diagnosis; verify the HCC assignment against the current CMS mapping for the applicable payment year. Coders reviewing F43.11 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-impact RAF improvement available within accurate coding.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for F43.11 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Document the onset date relative to the traumatic event to confirm acute timing
•Note when symptoms began and their duration to differentiate from chronic PTSD

Clinical Significance

Post-traumatic stress disorder, acute, specifies that PTSD symptoms have been present for less than 3 months. This specification is clinically important as acute PTSD has a different prognosis and treatment approach compared to chronic PTSD, with higher rates of spontaneous improvement. Early intervention during the acute phase can significantly improve outcomes.

Documentation Requirements

✓Documented exposure to a qualifying traumatic event
✓All four PTSD symptom clusters present: re-experiencing, avoidance, negative cognitions/mood, hyperarousal
✓Duration of symptoms greater than 1 month but less than 3 months
✓Onset related to identified traumatic event
✓Functional impairment documented
✓Current treatment plan including evidence-based trauma therapy

Commonly Confused Codes

•F43.12 (Post-traumatic stress disorder, chronic): Chronic PTSD requires symptoms lasting 3+ months; acute is less than 3 months
•F43.0 (Acute stress disorder): Acute stress disorder is within 3 days to 1 month; acute PTSD is 1-3 months after trauma
•F43.10 (Post-traumatic stress disorder, unspecified): Use F43.11 when documentation specifies the acute timeframe
•F43.22 (Adjustment disorder with anxiety): Adjustment disorder has less severe symptoms and may not involve a qualifying trauma