F50.023 ICD-10-CM Code: Anorexia nervosa, binge eating/purging type, extreme
F50.023 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)
F50.023
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceAnorexia nervosa, binge eating/purging type, extreme
A severe eating disorder where a person severely restricts food intake but also engages in cycles of binge eating followed by purging behaviors like vomiting or laxative use.
Buddy Insight
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.
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, binge eating/purging type, with a body mass index of less than 15.0 kg/m2
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for F50.023 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for F50.023 in this effective period.
Excludes 1
Official- bulimia nervosa (F50.2-)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for F50.023 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for F50.023 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for F50.023 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 F50.023 an HCC code?
Yes. F50.023 (Anorexia nervosa, binge eating/purging type, extreme) 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: F50.023 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
- F50.023
- Description
- Anorexia nervosa, binge eating/purging type, extreme
- 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 F50.023 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for F50.023
For F50.023 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 F50.023 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
F50.023 is the ICD-10-CM diagnosis code for anorexia nervosa, binge eating/purging type, extreme. A severe eating disorder where a person severely restricts food intake but also engages in cycles of binge eating followed by purging behaviors like vomiting or laxative use. F50.023 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, F50.023 maps to Personality Disorders; Anorexia/Bulimia Nervosa (HCC 153) with a community, non-dual, aged base RAF weight of 0.396. F50.023 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.
This code specifies the extreme severity level - ensure clinical documentation supports this level of severity before coding. Because F50.023 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 F50.023 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code specifies the extreme severity level - ensure clinical documentation supports this level of severity before coding
- •Do not use this code if the patient is in remission; use F50.024 instead
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. Extreme severity with BMI below 15 kg/m2 represents the most medically dangerous presentation, with imminent risk from both starvation and purging complications. 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 less than 15 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