F50.20 ICD-10-CM Code: Bulimia nervosa, unspecified
F50.20 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) / Behavioral syndromes associated with physiological disturbances and physical factors (F50-F59)
F50.20
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceBulimia nervosa, unspecified
Bulimia nervosa is an eating disorder characterized by repeated episodes of binge eating followed by compensatory behaviors such as self-induced vomiting, excessive exercise, or laxative abuse to prevent weight gain. The 'unspecified' designation indicates that the specific subtype or severity details are not documented.
Buddy Insight
Bulimia nervosa involves recurrent episodes of binge eating followed by inappropriate compensatory behaviors (self-induced vomiting, laxative/diuretic misuse, fasting, excessive exercise) in a patient at normal or above-normal weight.
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 094
Coefficient needs member context
ESRD/PACE
N/A—
Not mapped
RXHCC
MappedHCC 133
Code-level coefficient reference
Code Book Path
Inclusion Terms
Official- Bulimia NOSInherited from F50.2
- Hyperorexia nervosaInherited from F50.2
Excludes 2
Official- symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99)Inherited from F01-F99, F50
- feeding difficulties (R63.3-)Inherited from F01-F99, F50
- feeding disorder in infancy or childhood (F98.2-)Inherited from F01-F99, F50
Related Codes
Includes
Official- disorders of psychological developmentInherited from F01-F99
Excludes 1
Official- anorexia NOS (R63.0)Inherited from F50, F50.2
- feeding problems of newborn (P92.-)Inherited from F50, F50.2
- polyphagia (R63.2)Inherited from F50, F50.2
- anorexia nervosa, binge eating/purging type (F50.02-)Inherited from F50, F50.2
Code First
OfficialNo Code First sequencing instructions are included in this display for F50.20. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for F50.20. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for F50.20. 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 F50.20 an HCC code?
Yes. F50.20 (Bulimia nervosa, unspecified) 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: F50.20 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
- F50.20
- Description
- Bulimia nervosa, unspecified
- 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 F50.20 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for F50.20
For F50.20, 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
F50.20 is the ICD-10-CM diagnosis code for bulimia nervosa, unspecified. Bulimia nervosa is an eating disorder characterized by repeated episodes of binge eating followed by compensatory behaviors such as self-induced vomiting, excessive exercise, or laxative abuse to prevent weight gain. The 'unspecified' designation indicates that the specific subtype or severity details are not documented. F50.20 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, F50.20 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.
Verify documentation for subtype specificity - if the record indicates purging type (F50.21) or non-purging type (F50.22), use the more specific code rather than the unspecified code. For F50.20, 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 F50.20 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify documentation for subtype specificity - if the record indicates purging type (F50.21) or non-purging type (F50.22), use the more specific code rather than the unspecified code
- •Ensure the diagnosis is clearly documented as bulimia nervosa and not another eating disorder; review for any associated complications (electrolyte imbalances, dental erosion) that may require additional codes
Clinical Significance
Bulimia nervosa involves recurrent episodes of binge eating followed by inappropriate compensatory behaviors (self-induced vomiting, laxative/diuretic misuse, fasting, excessive exercise) in a patient at normal or above-normal weight. Unspecified severity indicates bulimia nervosa is diagnosed but the frequency of compensatory behaviors has not been documented. Unlike anorexia nervosa, patients with bulimia are not significantly underweight, which can make the condition less visually apparent.
Documentation Requirements
- ✓Recurrent episodes of binge eating (consuming objectively large amounts of food with sense of loss of control)
- ✓Recurrent inappropriate compensatory behaviors to prevent weight gain (Frequency not specified)
- ✓Binge eating and compensatory behaviors occur at least once per week for three months
- ✓Self-evaluation unduly influenced by body shape and weight
- ✓Disturbance does not occur exclusively during episodes of anorexia nervosa (patient is NOT significantly underweight)
Commonly Confused Codes
- •F50.02x (Anorexia nervosa, binge eating/purging type): patient is significantly UNDERWEIGHT, unlike bulimia
- •F50.81x (Binge eating disorder): binge eating WITHOUT compensatory purging behaviors
- •F50.9 (Eating disorder, unspecified): use specific bulimia code when criteria are documented
- •F50.89 (Other specified eating disorder): use for purging disorder (purging without binge eating) or subthreshold bulimia
- •E87.1 (Hypo-osmolality and hyponatremia): complication code, not the eating disorder itself