F48.1
BillableDepersonalization-derealization syndrome
HCC Category Mapping
V28HCC 153 — Personality Disorders and Dissociative Disorders
1.241V24HCC 60 — Personality Disorders
0.000ESRDHCC 60 — Personality Disorders
0.000RxHCCHCC 133 — Personality Disorders, Anxiety, and Other Specified Mental Disorders
0.000What This Code Means
A condition where a person experiences persistent feelings of detachment from their body, thoughts, or surroundings, or feels that the world around them is unreal or dreamlike.
Coding Tips
- •Document whether depersonalization (detachment from self) or derealization (detachment from environment) predominates
- •Ensure symptoms cause significant distress or functional impairment
Clinical Significance
Depersonalization-derealization syndrome involves persistent or recurrent experiences of feeling detached from one's mental processes or body (depersonalization) and/or feeling that surroundings are unreal (derealization). This condition causes significant functional impairment and psychiatric distress. It maps to HCC categories across multiple models, making it important for risk adjustment capture.
Documentation Requirements
- ✓Documentation of persistent or recurrent depersonalization (feeling detached from self) and/or derealization (surroundings feel unreal)
- ✓Intact reality testing during episodes — patient knows the experience is not real
- ✓Significant distress or functional impairment from the symptoms
- ✓Symptoms not occurring exclusively during another mental disorder (schizophrenia, panic disorder, PTSD)
- ✓Symptoms not attributable to substance use or medical condition
Commonly Confused Codes
F44.81 (Dissociative identity disorder) — involves distinct personality states, not just detachmentF44.9 (Dissociative disorder, unspecified) — use F48.1 when depersonalization/derealization is specifically documentedF41.0 (Panic disorder) — depersonalization can occur DURING panic attacks but is not the primary diagnosisF20.9 (Schizophrenia, unspecified) — derealization in schizophrenia is secondary; intact reality testing distinguishes depersonalization-derealizationF43.10 (Post-traumatic stress disorder, unspecified) — dissociative subtype of PTSD includes depersonalization but is coded under PTSD
Code Hierarchy
└F48Other nonpsychotic mental disorders└F48.1Depersonalization-derealization syndrome
└F48.1Depersonalization-derealization syndrome