F45.22
BillableBody dysmorphic disorder
HCC Category Mapping
RxHCCHCC 133 — Personality Disorders, Anxiety, and Other Specified Mental Disorders
0.000What This Code Means
A preoccupation with perceived defects or flaws in physical appearance that are not observable or appear slight to others, causing significant distress or impairment.
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 defectsF42.2 (Mixed obsessive thoughts and acts) — OCD may involve appearance but in broader obsessional contextF50.00-F50.9 (Eating disorders) — if preoccupation is specifically with weight/body fat, consider eating disorder codesF45.8 (Other somatoform disorders) — use for somatoform conditions not classified elsewhereL98.1 (Factitial dermatitis) — skin picking from body dysmorphic disorder should be coded with F45.22, not as dermatitis alone
Code Hierarchy
└F45Somatoform disorders└F45.2Hypochondriacal disorders└F45.22Body dysmorphic disorder
└F45.22Body dysmorphic disorder