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F51.02 ICD-10-CM Code: Adjustment insomnia

F51.02 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · HCC coding software

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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)

F51.02

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Adjustment insomnia

Insomnia that develops as a direct result of a stressful life event or significant change, such as a job loss, relationship problem, or major life transition. The sleep difficulty is temporary and typically resolves once the person adjusts to the new situation.

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
F51Sleep disorders not due to a substance or known physiological condition
F51.0Insomnia not due to a substance or known physiological condition
F51.02Adjustment insomnia

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for F51.02 in this effective period.

Excludes 2

Official
  • alcohol related insomnia (F10.182, F10.282, F10.982)
  • drug-related insomnia (F11.182, F11.282, F11.982, F13.182, F13.282, F13.982, F14.182, F14.282, F14.982, F15.182, F15.282, F15.982, F19.182, F19.282, F19.982)
  • insomnia NOS (G47.0-)
  • insomnia due to known physiological condition (G47.0-)
  • organic insomnia (G47.0-)

Related Child Codes

Official
F51.01Primary insomnia
F51.03Paradoxical insomnia
F51.04Psychophysiologic insomnia
F51.05Insomnia due to other mental disorder
F51.09Other insomnia not due to a substance or known physiological condition

Includes

Official

ICD-10-CM does not list Includes notes for F51.02 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for F51.02 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for F51.02 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for F51.02 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for F51.02 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Always identify and document the specific stressor or life event triggering the insomnia, as this distinguishes adjustment insomnia from other insomnia types
Verify that the insomnia onset is clearly related to the identified stressor and began within 3 months of the stressful event to support accurate coding

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 F51.02 an HCC code?

No. F51.02 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

Code
F51.02
Description
Adjustment insomnia
HCC (V28)
No CMS-HCC V28 mapping
RAF
Billable
Yes
Payment year
2026

Coder workflow notes

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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

F51.02 is the ICD-10-CM diagnosis code for adjustment insomnia. Insomnia that develops as a direct result of a stressful life event or significant change, such as a job loss, relationship problem, or major life transition. The sleep difficulty is temporary and typically resolves once the person adjusts to the new situation. F51.02 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).

F51.02 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

Always identify and document the specific stressor or life event triggering the insomnia, as this distinguishes adjustment insomnia from other insomnia types.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for F51.02 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Always identify and document the specific stressor or life event triggering the insomnia, as this distinguishes adjustment insomnia from other insomnia types
  • Verify that the insomnia onset is clearly related to the identified stressor and began within 3 months of the stressful event to support accurate coding

Child Codes

Code Hierarchy

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