F60.81
BillableNarcissistic personality disorder
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F60.81 an HCC code?
Yes. F60.81 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 F60.81
For F60.81 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 F60.81 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F60.81 is the ICD-10-CM diagnosis code for narcissistic personality disorder. A personality pattern involving excessive need for admiration, lack of empathy, and sense of entitlement or superiority. F60.81 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, F60.81 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, F60.81 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 grandiose fantasies, preoccupation with success or power, and interpersonal exploitation. Because F60.81 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 F60.81 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document grandiose fantasies, preoccupation with success or power, and interpersonal exploitation
- •Differentiate from healthy self-esteem; narcissistic personality disorder involves pervasive patterns causing functional impairment
Clinical Significance
Narcissistic personality disorder is a Cluster B personality disorder characterized by a pervasive pattern of grandiosity, need for admiration, and lack of empathy. It significantly impacts treatment compliance, provider-patient relationships, and healthcare utilization patterns, as these patients often present with somatic complaints and comorbid depression or substance abuse. Accurate coding captures the complexity of care for these patients.
Documentation Requirements
- ✓Documented pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy present since early adulthood
- ✓Evidence of at least five DSM-5 criteria met (grandiose sense of self-importance, preoccupation with fantasies of success, belief of being special, excessive need for admiration, sense of entitlement, interpersonal exploitation, lack of empathy, envy, arrogant behaviors)
- ✓Functional impairment in interpersonal, occupational, or social domains
- ✓Provider assessment distinguishing narcissistic PD from narcissistic traits or normal personality variation
- ✓Treatment plan documentation including psychotherapy approach
Commonly Confused Codes
- •F60.2 — Antisocial personality disorder; both are Cluster B and may involve exploitation, but antisocial PD features persistent violation of others' rights and legal problems
- •F60.4 — Histrionic personality disorder; both are Cluster B and seek attention, but histrionic PD involves excessive emotionality while narcissistic PD centers on grandiosity
- •F60.3 — Borderline personality disorder; both are Cluster B with relationship difficulties, but borderline PD features emotional instability and self-harm
- •F60.89 — Other specific personality disorders; use F60.81 specifically when narcissistic PD is documented