What is ICD-10 code F68.A?

F68.A is the ICD-10-CM diagnosis code for Factitious disorder imposed on another. A mental health condition where someone deliberately produces, exaggerates, or induces symptoms or illnesses in another person (often a dependent) to gain attention, sympathy, or control; also known as Munchausen syndrome by proxy. F68.A is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. F68.A 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.A 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.A 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.

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

F68.A does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither model rewards F68.A with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a payment HCC.

What should coders know when reporting F68.A?

Document evidence that symptoms are being deliberately induced or exaggerated by the perpetrator, not the patient Ensure proper documentation of the relationship between the perpetrator and victim

F68.A: Factitious disorder imposed on another — ICD-10

ICD-10-CM Code View

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Code lookupF68.AEffective 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.A

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

Factitious disorder imposed on another

A mental health condition where someone deliberately produces, exaggerates, or induces symptoms or illnesses in another person (often a dependent) to gain attention, sympathy, or control; also known as Munchausen syndrome by proxy.

Buddy Insight

CMS-HCC V28

Not risk-adjusted for this model/period.

RAF 0

CMS-HCC V24

Not risk-adjusted for this model/period.

RAF 0

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Not risk-adjusted for this model/period.

RAF 0

RXHCC

Mapped

HCC 133

Personality Disorders, Anxiet...

RAF 0.0

Code Trumping

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Code Book Path

Official

F68Other disorders of adult personality and behavior

F68.AFactitious disorder imposed on another

Inclusion Terms

Official

Factitious disorder by proxy
Münchausen's by proxy

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for F68.A in this effective period.

Related Child Codes

Official

F68.1Factitious disorder imposed on self

F68.8Other specified disorders of adult personality and behavior

Includes

Official

ICD-10-CM does not list Includes notes for F68.A in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for F68.A in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for F68.A in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for F68.A in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for F68.A in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Provider documentation that a caregiver is deliberately producing or falsifying illness in another person

Evidence of deliberate fabrication, exaggeration, or induction of symptoms in the victim

Documentation that the caregiver's behavior is not motivated by external rewards

This code is applied to the perpetrator's record — the victim receives codes for their actual conditions and abuse codes (T74/T76)

MEAT Support

HCC Buddy guidance

Provider documentation that a caregiver is deliberately producing or falsifying illness in another person

Evidence of deliberate fabrication, exaggeration, or induction of symptoms in the victim

Documentation that the caregiver's behavior is not motivated by external rewards

This code is applied to the perpetrator's record — the victim receives codes for their actual conditions and abuse codes (T74/T76)

Audit Caution

HCC Buddy guidance

Applying F68.A to the victim's record instead of the perpetrator's record — this code goes on the perpetrator's chart

Confusing factitious disorder imposed on another with medical child abuse (the legal term) — they are related but F68.A is the perpetrator's psychiatric diagnosis

Failing to code the victim's actual medical conditions and abuse codes (T74/T76) separately

Not recognizing the mandatory reporting obligations that come with this diagnosis

Common Mistakes

HCC Buddy guidance

F68.10-F68.13 — Factitious disorder imposed on self; those codes are for self-directed factitious behavior, not imposed on another person

T74.12XA — Child physical abuse, confirmed; the victim receives abuse codes, the perpetrator receives F68.A

T76.12XA — Child physical abuse, suspected; used when abuse is suspected but not yet confirmed

Z62.810 — Personal history of child physical abuse; for the victim's history, not the perpetrator's diagnosis

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is F68.A an HCC code?

No. F68.A is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

HCC Category Mapping

RxHCCHCC 133, Personality Disorders, Anxiety, and Other Specified Mental Disorders

0.000

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.

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

MEAT Criteria for F68.A

For F68.Ato 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 F68.A during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

F68.A is the ICD-10-CM diagnosis code for factitious disorder imposed on another. A mental health condition where someone deliberately produces, exaggerates, or induces symptoms or illnesses in another person (often a dependent) to gain attention, sympathy, or control; also known as Munchausen syndrome by proxy. F68.A 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.A is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

F68.A does not map to any HCC in V28 or V24 models. RxHCC maps to 133 (0.000). No RAF score impact. This code is primarily important for safeguarding, legal documentation, and coordination with protective services. Coders reviewing F68.A should check whether additional documentation would support a more specific child code in the same hierarchy that does map to a payment HCC, capturing the correct specificity is the highest-impact RAF improvement available within accurate coding.

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

Coding Tips

•Document evidence that symptoms are being deliberately induced or exaggerated by the perpetrator, not the patient
•Ensure proper documentation of the relationship between the perpetrator and victim

Clinical Significance

Factitious disorder imposed on another (formerly Munchausen syndrome by proxy) is a severe form of abuse where a caregiver deliberately falsifies or induces illness in someone under their care, typically a child. This is both a psychiatric diagnosis (applied to the perpetrator) and a child abuse condition with legal implications. Identification is critical for victim safety and is a mandatory reporting situation in all jurisdictions.

Documentation Requirements

✓Provider documentation that a caregiver is deliberately producing or falsifying illness in another person
✓Evidence of deliberate fabrication, exaggeration, or induction of symptoms in the victim
✓Documentation that the caregiver's behavior is not motivated by external rewards
✓This code is applied to the perpetrator's record — the victim receives codes for their actual conditions and abuse codes (T74/T76)
✓Documentation of mandatory reporting and protective services involvement

Commonly Confused Codes

•F68.10-F68.13: Factitious disorder imposed on self; those codes are for self-directed factitious behavior, not imposed on another person
•T74.12XA: Child physical abuse, confirmed; the victim receives abuse codes, the perpetrator receives F68.A
•T76.12XA: Child physical abuse, suspected; used when abuse is suspected but not yet confirmed
•Z62.810: Personal history of child physical abuse; for the victim's history, not the perpetrator's diagnosis