F45.22 ICD-10-CM Code: Body dysmorphic disorder
F45.22 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · HCC Buddy coding tools
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FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders (F40-F48)
F45.22
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceBody dysmorphic disorder
A preoccupation with perceived defects or flaws in physical appearance that are not observable or appear slight to others, causing significant distress or impairment.
Buddy Insight
Body dysmorphic disorder involves preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
MappedHCC 133
RAF 0.035
Code Book Path
Inclusion Terms
Official- Bigorexia
- Dysmorphophobia (nondelusional)
- Muscle dysmorphia
- Nosophobia
Excludes 2
Official- delusional dysmorphophobia (F22)
- fixed delusions about bodily functions or shape (F22)
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for F45.22 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for F45.22 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for F45.22 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for F45.22 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for F45.22 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 F45.22 an HCC code?
F45.22 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
- F45.22
- Description
- Body dysmorphic disorder
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
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 F45.22 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for F45.22
For F45.22 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 F45.22 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
F45.22 is the ICD-10-CM diagnosis code for body dysmorphic disorder. A preoccupation with perceived defects or flaws in physical appearance that are not observable or appear slight to others, causing significant distress or impairment. F45.22 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).
F45.22 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 F45.22 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 F45.22 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document that the appearance concern is not better explained by concerns about body fat or weight
- •Note repetitive behaviors such as mirror checking, grooming, or skin picking
Clinical Significance
Body dysmorphic disorder involves preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others. This condition carries significant psychiatric morbidity including high rates of suicidal ideation. Accurate coding is important for connecting patients to appropriate cognitive behavioral therapy and psychiatric management.
Documentation Requirements
- ✓Documentation of preoccupation with perceived physical defects not observable to others
- ✓Evidence of repetitive behaviors (mirror checking, skin picking, reassurance seeking) or mental acts related to the concern
- ✓Clinically significant distress or impairment in functioning
- ✓Differentiation from eating disorders if weight/body shape is the focus
- ✓Assessment of insight level (good, poor, absent/delusional)
Commonly Confused Codes
- •F45.21 (Hypochondriasis): focuses on illness/disease fear, not appearance defects
- •F42.2 (Mixed obsessive thoughts and acts): OCD may involve appearance but in broader obsessional context
- •F50.00-F50.9 (Eating disorders): if preoccupation is specifically with weight/body fat, consider eating disorder codes
- •F45.8 (Other somatoform disorders): use for somatoform conditions not classified elsewhere
- •L98.1 (Factitial dermatitis): skin picking from body dysmorphic disorder should be coded with F45.22, not as dermatitis alone