F60.0
BillableParanoid personality disorder
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F60.0 an HCC code?
Yes. F60.0 maps to Personality Disorders and Dissociative Disorders under the CMS-HCC V28 risk adjustment model (and Personality Disorders under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. 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.
MEAT Criteria for F60.0
For F60.0 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 F60.0 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F60.0 is the ICD-10-CM diagnosis code for paranoid personality disorder. A personality pattern characterized by persistent distrust and suspicion of others, interpreting their actions as deliberately harmful or threatening. F60.0 sits in the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99), within the section covering disorders of adult personality and behavior (f60-f69).
Under the CMS-HCC V28 risk adjustment model, F60.0 maps to Personality Disorders and Dissociative Disorders (HCC 153) with a community, non-dual, aged base RAF weight of 1.241. Under the older CMS-HCC V24 model, F60.0 maps to Personality Disorders (HCC 60) with a community, non-dual, aged base RAF weight of 0.000. 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.
Document specific examples of paranoid ideation or suspicious behavior patterns in the clinical record. Because F60.0 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 F60.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document specific examples of paranoid ideation or suspicious behavior patterns in the clinical record
- •Distinguish from paranoid delusions in psychotic disorders; paranoid personality disorder involves personality traits rather than fixed false beliefs
Clinical Significance
Paranoid personality disorder is characterized by a pervasive pattern of distrust and suspiciousness of others, interpreting their motives as malevolent. This enduring pattern significantly impacts healthcare engagement, medication compliance, and therapeutic relationships. Patients often refuse treatment or have adversarial relationships with providers, complicating management of comorbid conditions.
Documentation Requirements
- ✓Documentation of pervasive distrust and suspiciousness of others beginning by early adulthood
- ✓Evidence of at least four of the DSM-5 criteria (suspects exploitation/harm, doubts loyalty, reluctant to confide, reads demeaning meanings, bears grudges, perceives attacks on character, suspicious of partner fidelity)
- ✓Pattern is enduring, inflexible, and pervasive across contexts (not limited to specific situations)
- ✓Does not occur exclusively during schizophrenia, bipolar disorder, or depressive disorder with psychotic features
- ✓Functional impairment in occupational and interpersonal domains