What is ICD-10 code F44.81?

F44.81 is the ICD-10-CM diagnosis code for Dissociative identity disorder. A severe dissociative disorder where a person has multiple distinct personality states or identities, each with different memories, behaviors, and characteristics. It belongs to the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99). F44.81 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. F44.81 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. F44.81 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. F44.81 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.

What is the V28 vs V24 difference for F44.81?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For F44.81, V28 maps to Personality Disorders and Dissociative Disorders at RAF 1.241 while V24 mapped to Personality Disorders at RAF 0.000. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting F44.81?

Document the number of identities if specified and any history of trauma Ensure thorough psychiatric evaluation has confirmed the diagnosis before coding Because F44.81 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

F44.81 ICD-10 Code: Dissociative identity 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 lookupF44.81Effective 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)

F44.81

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

Dissociative identity disorder

A severe dissociative disorder where a person has multiple distinct personality states or identities, each with different memories, behaviors, and characteristics.

Buddy Insight

CMS-HCC V28

Mapped

HCC 153

Personality Disorders and Dis...

RAF 1.241

CMS-HCC V24

Mapped

HCC 60

Personality Disorders

RAF 0.0

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Mapped

HCC 60

Personality Disorders

RAF 0.0

RXHCC

Mapped

HCC 133

Personality Disorders, Anxiet...

RAF 0.0

Code Trumping

Basket needed

Compare selected patient codes to show trumped or trumps impact.

Code Book Path

Official

F44Dissociative and conversion disorders

F44.8Other dissociative and conversion disorders

F44.81Dissociative identity disorder

Inclusion Terms

Official

Multiple personality disorder

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for F44.81 in this effective period.

Related Child Codes

Official

F44.89Other dissociative and conversion disorders

Includes

Official

ICD-10-CM does not list Includes notes for F44.81 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for F44.81 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for F44.81 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for F44.81 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for F44.81 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documentation of two or more distinct personality states or identities with characteristic patterns of perception and behavior

Evidence of recurrent gaps in recall of everyday events, personal information, or traumatic events inconsistent with ordinary forgetting

Symptoms cause clinically significant distress or functional impairment

Documented psychiatric evaluation confirming diagnosis using DSM-5 criteria

MEAT Support

HCC Buddy guidance

Documentation of two or more distinct personality states or identities with characteristic patterns of perception and behavior

Evidence of recurrent gaps in recall of everyday events, personal information, or traumatic events inconsistent with ordinary forgetting

Symptoms cause clinically significant distress or functional impairment

Documented psychiatric evaluation confirming diagnosis using DSM-5 criteria

Audit Caution

HCC Buddy guidance

Coding dissociative identity disorder based on patient self-report alone without formal psychiatric evaluation documentation

Confusing with borderline personality disorder identity disturbance — dissociative identity disorder requires distinct personality states, not just unstable self-image

Failing to code comorbid PTSD (F43.1x) which is present in the vast majority of dissociative identity disorder patients

Using unspecified F44.9 when documentation clearly supports the specific diagnosis of dissociative identity disorder

Common Mistakes

HCC Buddy guidance

F44.89 (Other dissociative and conversion disorders) — use for dissociative conditions not meeting full criteria for dissociative identity disorder

F44.9 (Dissociative and conversion disorder, unspecified) — avoid when specific type can be identified

F48.1 (Depersonalization-derealization syndrome) — involves detachment from self/surroundings but NOT separate identity states

F60.3 (Borderline personality disorder) — may involve identity disturbance but not distinct alternate personalities

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 F44.81 an HCC code?

Yes. F44.81 maps to Personality Disorders and Dissociative Disorders under the CMS-HCC V28 risk adjustment model (and Personality Disorders under V24).

HCC Category Mapping

V28HCC 153, Personality Disorders and Dissociative Disorders

1.241

V24HCC 60, Personality Disorders

0.000

ESRDHCC 60, Personality Disorders

0.000

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 F44.81

For F44.81to 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 F44.81 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

F44.81 is the ICD-10-CM diagnosis code for dissociative identity disorder. A severe dissociative disorder where a person has multiple distinct personality states or identities, each with different memories, behaviors, and characteristics. F44.81 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).

Under the CMS-HCC V28 risk adjustment model, F44.81 maps to Personality Disorders and Dissociative Disorders (HCC 153) with a community, non-dual, aged base RAF weight of 1.241. Under the older CMS-HCC V24 model, F44.81 maps to Personality Disorders (HCC 60) with a community, non-dual, aged base RAF weight of 0.000. 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.

Document the number of identities if specified and any history of trauma. Because F44.81 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 F44.81 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Document the number of identities if specified and any history of trauma
•Ensure thorough psychiatric evaluation has confirmed the diagnosis before coding

Clinical Significance

Dissociative identity disorder (formerly multiple personality disorder) is a severe dissociative condition characterized by two or more distinct personality states with disruption in identity and consciousness. It is strongly associated with severe childhood trauma and carries high psychiatric morbidity. This diagnosis significantly impacts risk adjustment across multiple models, reflecting the intensive psychiatric treatment required.

Documentation Requirements

✓Documentation of two or more distinct personality states or identities with characteristic patterns of perception and behavior
✓Evidence of recurrent gaps in recall of everyday events, personal information, or traumatic events inconsistent with ordinary forgetting
✓Symptoms cause clinically significant distress or functional impairment
✓Documented psychiatric evaluation confirming diagnosis using DSM-5 criteria
✓Documentation that symptoms are not attributable to substance use or another medical condition

Commonly Confused Codes

•F44.89 (Other dissociative and conversion disorders) — use for dissociative conditions not meeting full criteria for dissociative identity disorder
•F44.9 (Dissociative and conversion disorder, unspecified) — avoid when specific type can be identified
•F48.1 (Depersonalization-derealization syndrome) — involves detachment from self/surroundings but NOT separate identity states
•F60.3 (Borderline personality disorder) — may involve identity disturbance but not distinct alternate personalities
•F44.0 (Dissociative amnesia) — memory loss without distinct personality states