What is ICD-10 code F44.5?

F44.5 is the ICD-10-CM diagnosis code for Conversion disorder with seizures or convulsions. A condition where psychological distress manifests as seizures or convulsions that mimic epilepsy but have no underlying neurological cause. It belongs to the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99). F44.5 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. F44.5 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. F44.5 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. F44.5 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 F44.5?

F44.5 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 model rewards F44.5 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a payment HCC.

What should coders know when reporting F44.5?

Document EEG findings or neurological evaluation confirming non-epileptic nature Differentiate from true seizure disorders by noting absence of typical EEG abnormalities

F44.5 ICD-10 Code: Conversion disorder

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 lookupF44.5Effective 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)

F44.5

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

Conversion disorder with seizures or convulsions

A condition where psychological distress manifests as seizures or convulsions that mimic epilepsy but have no underlying neurological cause.

Buddy Insight

Conversion disorder with seizures or convulsions (psychogenic non-epileptic seizures, or PNES) involves seizure-like episodes that are not caused by epileptic activity.

CMS-HCC V28

Not risk-adjusted for this model/period.

RAF 0

CMS-HCC V24

Not risk-adjusted for this model/period.

RAF 0

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Not risk-adjusted for this model/period.

RAF 0

RXHCC

Mapped

HCC 133

Personality Disorders, Anxiet...

RAF 0.0

Code Trumping

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Code Book Path

Official

F44Dissociative and conversion disorders

F44.5Conversion disorder with seizures or convulsions

Inclusion Terms

Official

Conversion disorder with attacks or seizures
Dissociative convulsions

Excludes 2

Official

malingering [conscious simulation] (Z76.5)

Related Child Codes

Official

F44.0Dissociative amnesia

F44.1Dissociative fugue

F44.2Dissociative stupor

F44.4Conversion disorder with motor symptom or deficit

F44.6Conversion disorder with sensory symptom or deficit

Includes

Official

conversion hysteria
conversion reaction
hysteria
hysterical psychosis

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for F44.5 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for F44.5 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for F44.5 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for F44.5 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Seizure-like episodes described with motor, behavioral, or experiential features

Video-EEG monitoring results showing no epileptiform activity during captured events (gold standard)

Clinical features inconsistent with epileptic seizures (e.g., prolonged duration, fluctuating course, asynchronous movements, eye closure during events, preserved awareness during bilateral convulsive movements)

Symptom causes clinically significant distress or functional impairment

MEAT Support

HCC Buddy guidance

Seizure-like episodes described with motor, behavioral, or experiential features

Video-EEG monitoring results showing no epileptiform activity during captured events (gold standard)

Symptom causes clinically significant distress or functional impairment

Audit Caution

HCC Buddy guidance

Coding PNES without video-EEG monitoring documentation — while not absolutely required, it is the diagnostic gold standard

Coding F44.5 when the patient has both PNES and epilepsy — both conditions can coexist; code both when documented

Continuing to prescribe and code anticonvulsant medications for confirmed PNES

Using seizure symptom codes (R56.9) after PNES diagnosis has been established

Common Mistakes

HCC Buddy guidance

G40.909 (Epilepsy, unspecified, not intractable, without status epilepticus) — True epilepsy confirmed by EEG; F44.5 is for non-epileptic events

F44.4 (Conversion disorder with motor symptom or deficit) — Use F44.4 for motor deficits (weakness, paralysis) without seizures; F44.5 is specifically for seizure presentations

G40.89 (Other seizures) — Use for seizures with an organic basis but not meeting specific epilepsy criteria

R56.9 (Unspecified convulsions) — Symptom code for convulsions before definitive diagnosis; use F44.5 once PNES is confirmed

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 F44.5 an HCC code?

No. F44.5 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

HCC Category Mapping

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

0.000

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 F44.5

For F44.5to 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 F44.5 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

F44.5 is the ICD-10-CM diagnosis code for conversion disorder with seizures or convulsions. A condition where psychological distress manifests as seizures or convulsions that mimic epilepsy but have no underlying neurological cause. F44.5 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).

F44.5 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.

F44.5 does not map to any HCC under V24 or V28 and has no RAF weight. No ESRD mapping. RxHCC maps to RxHCC 133 at 0.0 weight. Non-risk-adjusting diagnosis. This is notable given the significant diagnostic costs associated with video-EEG monitoring and the high resource utilization for management.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for F44.5 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Document EEG findings or neurological evaluation confirming non-epileptic nature
•Differentiate from true seizure disorders by noting absence of typical EEG abnormalities

Clinical Significance

Conversion disorder with seizures or convulsions (psychogenic non-epileptic seizures, or PNES) involves seizure-like episodes that are not caused by epileptic activity. PNES accounts for approximately 20-30% of patients referred to epilepsy centers. Misdiagnosis can lead to unnecessary anticonvulsant medications with their associated side effects and risks. Accurate diagnosis typically requires video-EEG monitoring.

Documentation Requirements

✓Seizure-like episodes described with motor, behavioral, or experiential features
✓Video-EEG monitoring results showing no epileptiform activity during captured events (gold standard)
✓Clinical features inconsistent with epileptic seizures (e.g., prolonged duration, fluctuating course, asynchronous movements, eye closure during events, preserved awareness during bilateral convulsive movements)
✓Symptom causes clinically significant distress or functional impairment
✓Neurological evaluation ruling out epilepsy
✓Assessment for comorbid conditions (PTSD, depression, anxiety, history of abuse)

Commonly Confused Codes

•G40.909 (Epilepsy, unspecified, not intractable, without status epilepticus) — True epilepsy confirmed by EEG; F44.5 is for non-epileptic events
•F44.4 (Conversion disorder with motor symptom or deficit) — Use F44.4 for motor deficits (weakness, paralysis) without seizures; F44.5 is specifically for seizure presentations
•G40.89 (Other seizures) — Use for seizures with an organic basis but not meeting specific epilepsy criteria
•R56.9 (Unspecified convulsions) — Symptom code for convulsions before definitive diagnosis; use F44.5 once PNES is confirmed