What is ICD-10 code F68.10?

F68.10 is the ICD-10-CM diagnosis code for Factitious disorder imposed on self, unspecified. A psychiatric condition where a person deliberately produces, exaggerates, or induces symptoms of illness in themselves to gain attention or sympathy, without a clear external reward. F68.10 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. F68.10 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. F68.10 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. F68.10 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does F68.10 map to under V28?

F68.10 has no payable CMS-HCC V28 mapping in the final FY2026 CMS file.

What RAF reference is published for F68.10?

F68.10 has no V28 reference coefficient because the final FY2026 source verifies no payable V28 mapping.

What is the V28 vs V24 difference for F68.10?

F68.10 has verified no payable V28 mapping in the final FY2026 source. Select a historical effective period before making any V24 comparison.

What documentation supports F68.10?

This differs from malingering (Z76.5) which involves external incentives like avoiding work Document the specific symptoms being fabricated and the pattern of deceptive behavior F68.10 is not a CMS-HCC V28 payment code in the verified current source, so MEAT is not the payment hook. Documentation still has to support the diagnosis if you report it.

Can F68.10 be a primary diagnosis?

Yes. F68.10 carries no code-first instruction in the FY2026 tabular, so it can be the first-listed diagnosis when it is the condition chiefly responsible for the encounter and the note supports it, and it can also be reported as a secondary diagnosis. For risk adjustment the order does not matter; the V28 category is the same either way.

Which codes cannot be reported with F68.10?

No Excludes1 note applies to F68.10 or its category in the FY2026 tabular, so there is no code the classification forbids alongside it. The Excludes2 note lists symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99); factitial dermatitis (L98.1); person feigning illness (with obvious motivation) (Z76.5); those are separate conditions that may be reported together with F68.10 when both are documented.

2026 ICD-10-CM F68.10: Factitious disorder imposed on self

F68.10 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools

ICD-10-CM Code View

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Code lookupF68.10

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Disorders of adult personality and behavior (F60-F69)

F68.10

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Factitious disorder imposed on self, unspecified

A psychiatric condition where a person deliberately produces, exaggerates, or induces symptoms of illness in themselves to gain attention or sympathy, without a clear external reward.

Buddy Insight

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

N/A

—

Not risk-adjusted for this model/period.

Not mapped

RXHCC

Mapped

HCC 133

Anxiety and Other Psychiatric...

Code-level coefficient reference

Code Book Path

Official

F68Other disorders of adult personality and behavior F68.1Factitious disorder imposed on self F68.10Factitious disorder imposed on self, unspecified

Inclusion Terms

Official

Compensation neurosisInherited from F68.1
Elaboration of physical symptoms for psychological reasonsInherited from F68.1
Hospital hopper syndromeInherited from F68.1
Münchausen's syndromeInherited from F68.1
Peregrinating patientInherited from F68.1

Excludes 2

Official

symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99)Inherited from F01-F99, F68.1
factitial dermatitis (L98.1)Inherited from F01-F99, F68.1
person feigning illness (with obvious motivation) (Z76.5)Inherited from F01-F99, F68.1

Related Codes

Official

F68.11Factitious disorder imposed on self, with predominantly psychological signs and symptoms F68.12Factitious disorder imposed on self, with predominantly physical signs and symptoms F68.13Factitious disorder imposed on self, with combined psychological and physical signs and symptoms

Includes

Official

disorders of psychological developmentInherited from F01-F99

Excludes 1

Official

No Excludes 1 notes are included in this display for F68.10. Check the code and parent instructions in the Code Book.

Code First

Official

No Code First sequencing instructions are included in this display for F68.10. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for F68.10. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for F68.10. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Provider documentation explicitly stating factitious disorder diagnosis

Evidence of deliberate falsification, simulation, or induction of physical or psychological signs/symptoms

Documentation that deceptive behavior persists even in the absence of obvious external rewards (distinguishing from malingering)

Clinical evidence supporting the deliberate nature of symptom production (e.g., lab findings inconsistent with reported symptoms, witness observation)

MEAT Support

HCC Buddy guidance

Provider documentation explicitly stating factitious disorder diagnosis

Evidence of deliberate falsification, simulation, or induction of physical or psychological signs/symptoms

Documentation that deceptive behavior persists even in the absence of obvious external rewards (distinguishing from malingering)

Clinical evidence supporting the deliberate nature of symptom production (e.g., lab findings inconsistent with reported symptoms, witness observation)

Audit Caution

HCC Buddy guidance

Using the unspecified F68.10 when the presentation is clearly predominantly psychological (F68.11) or physical (F68.12)

Confusing factitious disorder with malingering — the key distinction is the absence of external rewards in factitious disorder

Confusing factitious disorder with somatic symptom disorder — factitious involves deliberate deception while somatic symptom disorder does not

Failing to code factitious disorder due to sensitivity around the diagnosis or fear of provider-patient relationship damage

Common Mistakes

HCC Buddy guidance

F68.11 — Factitious disorder imposed on self, with predominantly psychological signs; use this when the factitious presentation is primarily psychiatric

F68.12 — Factitious disorder imposed on self, with predominantly physical signs; use this when the factitious presentation is primarily somatic

Z76.5 — Malingerer; malingering involves obvious external incentives (disability payments, avoiding duty) while factitious disorder does not

F45.x — Somatic symptom and related disorders; somatic symptom disorders involve genuine distress about symptoms without deliberate falsification

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 F68.10 an HCC code?

F68.10 is not in the CMS-HCC V28 or V24 community payment model. F68.10 has a separate mapping under the Part D RxHCC model (HCC 133 (Anxiety and Other Psychiatric Disorders)); the applicable result needs member context.

Code: F68.10
Description: Factitious disorder imposed on self, unspecified
HCC (V28): No CMS-HCC V28 mapping
RAF reference coefficient: —
Billable: Yes
Payment year: 2026

HCC Category Mapping

RxHCCHCC 133, Anxiety and Other Psychiatric Disorders

Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work F68.10 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for F68.10

For F68.10, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

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

Coder workflow notes

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What This Code Means

F68.10 is the ICD-10-CM diagnosis code for factitious disorder imposed on self, unspecified. A psychiatric condition where a person deliberately produces, exaggerates, or induces symptoms of illness in themselves to gain attention or sympathy, without a clear external reward. F68.10 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).

F68.10 has no mapping under the CMS-HCC V28 or V24 community payment models. F68.10 has a separate mapping under the Part D RxHCC model (HCC 133 (Anxiety and Other Psychiatric Disorders)); the applicable result needs member context. Do not assign V28 risk adjustment value from this page; verify the applicable model and payment year before using this code for risk adjustment.

This differs from malingering (Z76.5) which involves external incentives like avoiding work.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for F68.10 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•This differs from malingering (Z76.5) which involves external incentives like avoiding work
•Document the specific symptoms being fabricated and the pattern of deceptive behavior

Clinical Significance

Factitious disorder imposed on self (formerly Munchausen syndrome) involves deliberate falsification of medical or psychological signs and symptoms, or induction of injury or disease, in the absence of obvious external rewards. These patients drive enormous healthcare costs through unnecessary testing, procedures, and hospitalizations. Accurate identification is essential for patient safety and resource stewardship.

Documentation Requirements

✓Provider documentation explicitly stating factitious disorder diagnosis
✓Evidence of deliberate falsification, simulation, or induction of physical or psychological signs/symptoms
✓Documentation that deceptive behavior persists even in the absence of obvious external rewards (distinguishing from malingering)
✓Clinical evidence supporting the deliberate nature of symptom production (e.g., lab findings inconsistent with reported symptoms, witness observation)
✓Psychiatric evaluation and treatment plan

Commonly Confused Codes

•F68.11: Factitious disorder imposed on self, with predominantly psychological signs; use this when the factitious presentation is primarily psychiatric
•F68.12: Factitious disorder imposed on self, with predominantly physical signs; use this when the factitious presentation is primarily somatic
•Z76.5: Malingerer; malingering involves obvious external incentives (disability payments, avoiding duty) while factitious disorder does not
•F45.x: Somatic symptom and related disorders; somatic symptom disorders involve genuine distress about symptoms without deliberate falsification

Child Codes

F68.10Factitious disorder imposed on self, unspecified

F68.11Factitious disorder imposed on self, with predominantly psychological signs and symptoms

F68.12Factitious disorder imposed on self, with predominantly physical signs and symptoms

F68.13Factitious disorder imposed on self, with combined psychological and physical signs and symptoms

Code Hierarchy

└F68Other disorders of adult personality and behavior └F68.1Factitious disorder imposed on self └F68.10Factitious disorder imposed on self, unspecified

└F68.10Factitious disorder imposed on self, unspecified

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F68.10

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MEAT review for F68.10

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What This Code Means

Coding Tips

Clinical Significance

Documentation Requirements

Commonly Confused Codes

Child Codes

Code Hierarchy

F68.10 code history

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F68.10 ICD-10-CM Code: Factitious disorder imposed on self, unspecified

HCC Buddy Code Card

F68.10

Is F68.10 an HCC code?

HCC Category Mapping

MEAT review for F68.10

Get the V28 mapping + MEAT cheat sheet

What This Code Means

Coding Tips

Clinical Significance

Documentation Requirements

Commonly Confused Codes

Child Codes

Code Hierarchy

F68.10 code history

Also searched as

Work F68.10 in HCC Buddy