Question 1

What is ICD-10 code F52.6?

Accepted Answer

F52.6 is the ICD-10-CM diagnosis code for dyspareunia not due to a substance or known physiological condition. Pain during sexual intercourse that is not caused by a medical condition or physical abnormality. F52.6 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).

F52.6 is a billable ICD-10-CM code, but the current payload does not show a mapping under the CMS-HCC V28 or V24 community payment models, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.

Rule out medical causes such as endometriosis, pelvic inflammatory disease, or anatomical abnormalities before coding.

Question 2

Is F52.6 an HCC code?

Accepted Answer

F52.6 has no payable CMS-HCC V28 mapping in the final FY2026 CMS file.

Question 3

Is F52.6 billable?

Accepted Answer

Yes. F52.6 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. F52.6 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Question 4

Which HCC does F52.6 map to under V28?

Accepted Answer

F52.6 has no payable CMS-HCC V28 mapping in the final FY2026 CMS file.

Question 5

What RAF reference is published for F52.6?

Accepted Answer

F52.6 has no V28 reference coefficient because the final FY2026 source verifies no payable V28 mapping.

Question 6

What is the V28 vs V24 difference for F52.6?

Accepted Answer

F52.6 has verified no payable V28 mapping in the final FY2026 source. Select a historical effective period before making any V24 comparison.

Question 7

What documentation supports F52.6?

Accepted Answer

Rule out medical causes such as endometriosis, pelvic inflammatory disease, or anatomical abnormalities before coding Specify whether pain occurs during penetration, deep penetration, or throughout intercourse F52.6 is not a CMS-HCC V28 payment code in the verified current source, so MEAT is not the payment hook. Documentation still has to support the diagnosis if you report it.

Question 8

Can F52.6 be a primary diagnosis?

Accepted Answer

Yes. F52.6 carries no code-first instruction in the FY2026 tabular, so it can be the first-listed diagnosis when it is the condition chiefly responsible for the encounter and the note supports it, and it can also be reported as a secondary diagnosis. For risk adjustment the order does not matter; the V28 category is the same either way.

Question 9

Which codes cannot be reported with F52.6?

Accepted Answer

No Excludes1 note applies to F52.6 or its category in the FY2026 tabular, so there is no code the classification forbids alongside it. The Excludes2 note lists dyspareunia (due to a known physiological condition) (N94.1-); symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99); Dhat syndrome (F48.8); those are separate conditions that may be reported together with F52.6 when both are documented.

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F52.6

Is F52.6 an HCC code?

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Excludes 2, Not included here, may code separately

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F52.6 ICD-10-CM Code: Dyspareunia not due to a substance or known physiological condition

HCC Buddy Code Card

F52.6

Is F52.6 an HCC code?

Get the V28 mapping + MEAT cheat sheet

What This Code Means

Coding Tips

Excludes 2, Not included here, may code separately

Child Codes

Code Hierarchy

Also searched as

Work F52.6 in HCC Buddy