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F45

Non-Billable (Header)

Somatoform disorders

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

What This Code Means

F45 is the ICD-10-CM diagnosis code for somatoform disorders. F45 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).

Header codes like F45 cannot be reported on claims directly — they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at F45's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for F45 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Excludes 2 — Not included here, may code separately

  • dissociative and conversion disorders (F44.-)
  • factitious disorders (F68.1-, F68.A)
  • hair-plucking (F63.3)
  • lalling (F80.0)
  • lisping (F80.0)
  • malingering [conscious simulation] (Z76.5)
  • nail-biting (F98.8)
  • psychological or behavioral factors associated with disorders or diseases classified elsewhere (F54)
  • sexual dysfunction, not due to a substance or known physiological condition (F52.-)
  • thumb-sucking (F98.8)
  • tic disorders (in childhood and adolescence) (F95.-)
  • Tourette's syndrome (F95.2)
  • trichotillomania (F63.3)

Child Codes

Code Hierarchy

F45Somatoform disorders
F45Somatoform disorders

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