F50.011 ICD-10-CM Code: Anorexia nervosa, restricting type, moderate
F50.011 maps to CMS-HCC V28 153 (RAF 0.396). Documentation must support MEAT. MEAT criteria · RAF calculator · HCC Buddy coding tools
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FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Behavioral syndromes associated with physiological disturbances and physical factors (F50-F59)
F50.011
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceAnorexia nervosa, restricting type, moderate
Anorexia nervosa with food restriction as the primary method of weight control, at moderate severity with noticeable functional impairment and some medical complications.
Buddy Insight
Anorexia nervosa, restricting type involves weight loss achieved primarily through dieting, fasting, or excessive exercise without binge eating or purging behaviors.
CMS-HCC V28
MappedHCC 153
RAF 0.396
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
MappedHCC 94
Varies by metal level
ESRD/PACE
N/A—
Not mapped
RXHCC
MappedHCC 133
RAF 0.035
Code Book Path
Inclusion Terms
Official- Anorexia nervosa, restricting type, with a body mass index of 16.0-16.99 kg/m2
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for F50.011 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for F50.011 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for F50.011 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for F50.011 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for F50.011 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for F50.011 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 F50.011 an HCC code?
Yes. F50.011 (Anorexia nervosa, restricting type, moderate) maps to Personality Disorders; Anorexia/Bulimia Nervosa under the CMS-HCC V28 risk adjustment model, with a community non-dual aged RAF of 0.396. It is billable for payment year 2026.
Coder answer: F50.011 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
- F50.011
- Description
- Anorexia nervosa, restricting type, moderate
- HCC (V28)
- HCC 153 — Personality Disorders; Anorexia/Bulimia Nervosa
- RAF
- 0.396
- 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 F50.011 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for F50.011
For F50.011 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 F50.011 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
F50.011 is the ICD-10-CM diagnosis code for anorexia nervosa, restricting type, moderate. Anorexia nervosa with food restriction as the primary method of weight control, at moderate severity with noticeable functional impairment and some medical complications. F50.011 sits in the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99), within the section covering behavioral syndromes associated with physiological disturbances and physical factors (f50-f59).
Under the CMS-HCC V28 risk adjustment model, F50.011 maps to Personality Disorders; Anorexia/Bulimia Nervosa (HCC 153) with a community, non-dual, aged base RAF weight of 0.396. F50.011 was not retained as a payment HCC under the older V24 model, so V28 introduced or recategorized it during the 2024–2026 phase-in. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
Moderate severity indicates significant functional impairment and possible medical complications requiring closer monitoring. Because F50.011 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. 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, RAF weights, and MEAT documentation criteria for F50.011 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Moderate severity indicates significant functional impairment and possible medical complications requiring closer monitoring
- •Document the specific severity indicators in the medical record to support this level of coding
Clinical Significance
Anorexia nervosa, restricting type involves weight loss achieved primarily through dieting, fasting, or excessive exercise without binge eating or purging behaviors. Moderate severity indicates BMI between 16 and 16.99 kg/m2, representing significant nutritional compromise requiring close monitoring. This subtype carries significant risk for malnutrition, cardiac arrhythmias, and osteoporosis.
Documentation Requirements
- ✓Documentation of restricting behaviors (dieting, fasting, excessive exercise) WITHOUT binge eating or purging
- ✓Current BMI or weight documenting severity level (BMI 16.00-16.99 kg/m2)
- ✓Distorted body image or intense fear of weight gain
- ✓Duration and course of illness
- ✓Medical monitoring results (vital signs, electrolytes, cardiac evaluation)
Commonly Confused Codes
- •F50.02x (Anorexia nervosa, binge eating/purging type): use when binge/purge behaviors are present in addition to restriction
- •F50.00 (Anorexia nervosa, unspecified): use F50.01x when restricting type is specifically documented
- •F50.82 (Avoidant/restrictive food intake disorder): food restriction NOT driven by body image disturbance or fear of weight gain
- •R63.0 (Anorexia): medical loss of appetite, NOT the psychiatric eating disorder
- •E44.0-E44.1 (Protein-calorie malnutrition): may coexist; code both when documented