F50.013
BillableAnorexia nervosa, restricting type, extreme
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F50.013 an HCC code?
Yes. F50.013 maps to Personality Disorders and Dissociative Disorders under the CMS-HCC V28 risk adjustment model.
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. 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.
MEAT Criteria for F50.013
For F50.013 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 F50.013 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F50.013 is the ICD-10-CM diagnosis code for anorexia nervosa, restricting type, extreme. Anorexia nervosa with restricting type at the most severe level, indicating extreme functional impairment and serious medical complications that pose significant health risks. F50.013 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, F50.013 maps to Personality Disorders and Dissociative Disorders (HCC 153) with a community, non-dual, aged base RAF weight of 1.241. F50.013 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.
Extreme severity is the highest level and indicates life-threatening condition requiring intensive treatment. Because F50.013 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 F50.013 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Extreme severity is the highest level and indicates life-threatening condition requiring intensive treatment
- •Ensure documentation clearly supports extreme severity with evidence of critical medical complications or dangerously low BMI
Clinical Significance
Anorexia nervosa, restricting type involves weight loss achieved primarily through dieting, fasting, or excessive exercise without binge eating or purging behaviors. Extreme severity with BMI below 15 kg/m2 indicates critical malnutrition with imminent risk of medical complications and death. 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 less than 15 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