F48.1 ICD-10-CM Code: Depersonalization-derealization syndrome
F48.1 maps to CMS-HCC V28 153. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. 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)
F48.1
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceDepersonalization-derealization syndrome
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.
Buddy Insight
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).
CMS-HCC V28
MappedHCC 153
Coefficient HCC 153: 0.396 (Community Non-Dual Aged (CNA))
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
Context neededHCC 090
Coefficient needs member context
ESRD/PACE
Context neededHCC 60
Coefficient needs member context
RXHCC
MappedHCC 133
Code-level coefficient reference
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for F48.1. Check the code and parent instructions in the Code Book.
Excludes 2
Official- symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99)Inherited from F01-F99
Related Codes
Includes
Official- disorders of psychological developmentInherited from F01-F99
Excludes 1
OfficialNo Excludes 1 notes are included in this display for F48.1. Check the code and parent instructions in the Code Book.
Code First
OfficialNo Code First sequencing instructions are included in this display for F48.1. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for F48.1. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for F48.1. Check the code and parent instructions in the Code Book.
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 F48.1 an HCC code?
Yes. F48.1 (Depersonalization-derealization syndrome) maps to HCC 153, Personality Disorders; Anorexia/Bulimia Nervosa under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.396. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.
Coder answer: F48.1 is billable and maps to V28 HCC 153, Personality Disorders; Anorexia/Bulimia Nervosa. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.
- Code
- F48.1
- Description
- Depersonalization-derealization syndrome
- HCC (V28)
- HCC 153 — Personality Disorders; Anorexia/Bulimia Nervosa
- RAF reference coefficient
- 0.396
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. 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 context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.
Work F48.1 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for F48.1
For F48.1, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.
- 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
Coder workflow notes
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What This Code Means
F48.1 is the ICD-10-CM diagnosis code for depersonalization-derealization syndrome. 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. F48.1 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, F48.1 maps to Personality Disorders; Anorexia/Bulimia Nervosa (HCC 153) with a source-labeled community, non-dual, aged reference coefficient of 0.396. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.
Document whether depersonalization (detachment from self) or derealization (detachment from environment) predominates. For F48.1, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. 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, source-labeled coefficient references, and MEAT documentation criteria for F48.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
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 detachment
- •F44.9 (Dissociative disorder, unspecified): use F48.1 when depersonalization/derealization is specifically documented
- •F41.0 (Panic disorder): depersonalization can occur DURING panic attacks but is not the primary diagnosis
- •F20.9 (Schizophrenia, unspecified): derealization in schizophrenia is secondary; intact reality testing distinguishes depersonalization-derealization
- •F43.10 (Post-traumatic stress disorder, unspecified): dissociative subtype of PTSD includes depersonalization but is coded under PTSD