F59 ICD-10-CM Code: Unspecified behavioral syndromes associated with physiological disturbances and physical factors
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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)
F59
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceUnspecified behavioral syndromes associated with physiological disturbances and physical factors
A behavioral or psychological syndrome related to physical disturbances or medical conditions that cannot be more specifically classified. The symptoms are tied to physiological factors rather than a primary mental disorder.
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
Inclusion Terms
Official- Psychogenic physiological dysfunction NOS
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for F59 in this effective period.
Related Child Codes
ICD-10-CM does not list child codes under F59 for this display context.
Includes
OfficialICD-10-CM does not list Includes notes for F59 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for F59 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for F59 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for F59 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for F59 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is F59 an HCC code?
No. F59 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
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
F59 is the ICD-10-CM diagnosis code for unspecified behavioral syndromes associated with physiological disturbances and physical factors. A behavioral or psychological syndrome related to physical disturbances or medical conditions that cannot be more specifically classified. The symptoms are tied to physiological factors rather than a primary mental disorder. F59 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).
F59 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.
This is a residual code used when a more specific behavioral syndrome code cannot be assigned.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for F59 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a residual code used when a more specific behavioral syndrome code cannot be assigned
- •Ensure documentation establishes the connection between the behavioral symptoms and the underlying physiological disturbance