F60.3
BillableBorderline personality disorder
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F60.3 an HCC code?
Yes. F60.3 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 F60.3
For F60.3 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 F60.3 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F60.3 is the ICD-10-CM diagnosis code for borderline personality disorder. A personality pattern characterized by unstable relationships, intense fear of abandonment, impulsive behaviors, and emotional instability. F60.3 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, F60.3 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, F60.3 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 relationship instability, self-harm behaviors, or identity disturbance. Because F60.3 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 F60.3 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document specific examples of relationship instability, self-harm behaviors, or identity disturbance
- •Ensure criteria are met across multiple life domains and not attributable to another mental disorder or medical condition
Clinical Significance
Borderline personality disorder is characterized by pervasive instability of interpersonal relationships, self-image, and affect, with marked impulsivity. It is the most commonly diagnosed personality disorder in clinical settings and carries a 10% lifetime suicide rate. Patients frequently present to emergency departments for self-harm, suicidal gestures, and emotional crises, making it a high-resource utilization condition.
Documentation Requirements
- ✓Documentation of pervasive pattern of instability in relationships, self-image, and affect with impulsivity beginning by early adulthood
- ✓Evidence of at least five DSM-5 criteria (frantic avoidance of abandonment, unstable relationships, identity disturbance, impulsivity, recurrent suicidal behavior/self-harm, affective instability, chronic emptiness, inappropriate anger, transient paranoia/dissociation)
- ✓Pattern is enduring and pervasive, not limited to mood episodes
- ✓Assessment of current self-harm and suicidal risk
- ✓Differentiation from bipolar disorder rapid cycling and complex PTSD
Excludes 2 — Not included here, may code separately
- antisocial personality disorder (F60.2)
Commonly Confused Codes
- •F31.x (Bipolar disorder) — mood cycling in bipolar is episodic; borderline mood shifts are rapid (hours to days) and reactive
- •F43.10 (PTSD, unspecified) — complex PTSD overlaps significantly but is a response to trauma, not a personality pattern per se
- •F60.2 (Antisocial personality disorder) — impulsivity and recklessness overlap, but borderline features fear of abandonment and emotional dysregulation
- •F60.4 (Histrionic personality disorder) — attention seeking and emotionality overlap, but borderline includes self-harm and identity disturbance
- •F44.81 (Dissociative identity disorder) — borderline may include transient dissociation, but does not involve distinct identity states