F65.4 ICD-10-CM Code: Pedophilia
F65.4 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools
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FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Disorders of adult personality and behavior (F60-F69)
F65.4
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidancePedophilia
A psychiatric disorder involving sexual interest in prepubescent children, with or without acting on these urges.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- Pedophilic disorder
Excludes 2
Official- symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99)Inherited from F01-F99
Related Codes
Includes
Official- disorders of psychological developmentInherited from F01-F99
Excludes 1
OfficialNo Excludes 1 notes are included in this display for F65.4. Check the code and parent instructions in the Code Book.
Code First
OfficialNo Code First sequencing instructions are included in this display for F65.4. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for F65.4. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for F65.4. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is F65.4 an HCC code?
No. F65.4 is a billable ICD-10-CM code with no mapping under the CMS-HCC V28 or V24 community payment models, and none under the ESRD, Part D RxHCC, or HHS-HCC models.
- Code
- F65.4
- Description
- Pedophilia
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
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
F65.4 is the ICD-10-CM diagnosis code for pedophilia. A psychiatric disorder involving sexual interest in prepubescent children, with or without acting on these urges. F65.4 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).
F65.4 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.
This is a serious diagnosis requiring careful documentation and often mandatory reporting obligations.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for F65.4 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a serious diagnosis requiring careful documentation and often mandatory reporting obligations
- •Specify whether the attraction is to males, females, or both when documented