F50.021
BillableAnorexia nervosa, binge eating/purging type, moderate
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F50.021 an HCC code?
Yes. F50.021 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 F50.021
For F50.021 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 F50.021 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F50.021 is the ICD-10-CM diagnosis code for anorexia nervosa, binge eating/purging type, moderate. Anorexia nervosa where the person restricts food intake but also engages in binge eating and purging behaviors, at moderate severity with noticeable functional and medical impact. F50.021 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, F50.021 maps to Personality Disorders and Dissociative Disorders (HCC 153) with a community, non-dual, aged base RAF weight of 1.241. F50.021 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.
Binge eating/purging type indicates the presence of both restriction and compensatory behaviors like vomiting or laxative use. Because F50.021 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 F50.021 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Binge eating/purging type indicates the presence of both restriction and compensatory behaviors like vomiting or laxative use
- •Moderate severity suggests significant functional impairment and medical complications requiring active treatment
Clinical Significance
Anorexia nervosa, binge eating/purging type involves episodes of binge eating and/or purging (self-induced vomiting, laxative/diuretic misuse) in a patient who meets low-weight criteria for anorexia nervosa. Moderate severity with BMI 16-16.99 kg/m2 indicates significant nutritional and metabolic compromise from combined restriction and purging. This subtype carries additional risks of electrolyte imbalances, esophageal tears, and dental erosion compared to the restricting type.
Documentation Requirements
- ✓Documentation of binge eating episodes and/or purging behaviors (vomiting, laxatives, diuretics) in the context of low body weight
- ✓Current BMI or weight documenting severity (BMI 16.00-16.99 kg/m2)
- ✓Distinction from bulimia nervosa (patient must meet low-weight criteria for anorexia nervosa)
- ✓Frequency of binge/purge episodes
- ✓Medical monitoring for purging complications (electrolytes, dental health, esophageal integrity, cardiac status)
Commonly Confused Codes
- •F50.01x (Anorexia nervosa, restricting type) — NO binge/purge behaviors present in restricting type
- •F50.2x (Bulimia nervosa) — patient is at NORMAL or above-normal weight, unlike anorexia nervosa binge/purge type
- •F50.81x (Binge eating disorder) — no compensatory purging behaviors and typically overweight/obese
- •F50.00 (Anorexia nervosa, unspecified) — use the specific type code when binge/purge behaviors are documented
- •E87.6 (Hypokalemia) — common complication to code separately