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F84.3 ICD-10-CM Code: Other childhood disintegrative disorder

F84.3 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools

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Code lookupF84.3

FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Pervasive and specific developmental disorders (F80-F89)

F84.3

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

Other childhood disintegrative disorder

A developmental disorder where a child shows normal development for at least 2 years, then experiences a significant loss of previously acquired skills in multiple areas.

Buddy the Bee presenting code insight

Buddy Insight

Childhood disintegrative disorder (Heller's syndrome) is a rare condition characterized by normal development for at least 2 years followed by clinically significant regression in multiple areas of functioning (language, social skills, bowel/bladder control, play, motor skills).

OverviewRisk ModelsCode BookDocumentationAuditNotesEdition comparison

CMS-HCC V28

N/A

—

Not mapped

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

Context needed

HCC 103

Coefficient needs member context

ESRD/PACE

N/A

—

Not mapped

RXHCC

Context needed

HCC 133

Coefficient needs member context

Code Book Path

Official
F84Pervasive developmental disordersF84.3Other childhood disintegrative disorder

Inclusion Terms

Official
  • Dementia infantilis
  • Disintegrative psychosis
  • Heller's syndrome
  • Symbiotic psychosis

Excludes 2

Official
  • symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99)Inherited from F01-F99

Related Codes

Official
F84.0Autistic disorderF84.2Rett's syndromeF84.5Asperger's syndromeF84.8Other pervasive developmental disordersF84.9Pervasive developmental disorder, unspecified

Includes

Official
  • disorders of psychological developmentInherited from F01-F99

Excludes 1

Official
  • Asperger's syndrome (F84.5)
  • Autistic disorder (F84.0)
  • Rett's syndrome (F84.2)

Code First

Official

No Code First sequencing instructions are included in this display for F84.3. Check the code and parent instructions in the Code Book.

Use Additional

Official
  • code to identify any associated neurological condition.

Code Also

Official
  • any associated medical condition and intellectual disabilitiesInherited from F84

Buddy Documentation Tip

HCC Buddy guidance
Provider documentation of childhood disintegrative disorder diagnosis
Evidence of apparently normal development for at least the first 2 years of life (normal age-appropriate verbal/nonverbal communication, social relationships, play, adaptive behavior)
Documentation of clinically significant loss of previously acquired skills in at least two areas
Exclusion of other conditions that could account for the regression (e.g., metabolic disorders, degenerative neurological conditions)

MEAT Support

HCC Buddy guidance
Provider documentation of childhood disintegrative disorder diagnosis
Evidence of apparently normal development for at least the first 2 years of life (normal age-appropriate verbal/nonverbal communication, social relationships, play, adaptive behavior)
Documentation of clinically significant loss of previously acquired skills in at least two areas
Exclusion of other conditions that could account for the regression (e.g., metabolic disorders, degenerative neurological conditions)

Audit Caution

HCC Buddy guidance
Confusing CDD with autistic regression — CDD requires documented normal development for at least 2 years followed by loss in multiple domains
Not excluding metabolic and neurodegenerative conditions that can mimic CDD
Using F84.9 (unspecified) when childhood disintegrative disorder has been specifically diagnosed
Failing to code comorbid conditions (seizures, behavioral disturbances, intellectual disability) separately

Common Mistakes

HCC Buddy guidance
F84.0 — Autistic disorder; autism typically presents earlier and with less dramatic regression than CDD
F84.2 — Rett's syndrome; Rett also involves regression but has specific genetic (MECP2) and clinical features (hand stereotypies)
G31.x — Degenerative diseases of the nervous system; neurodegenerative conditions must be ruled out
F84.9 — Pervasive developmental disorder, unspecified; use F84.3 when CDD is specifically documented

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 F84.3 an HCC code?

F84.3 is not in the CMS-HCC V28 or V24 community payment model. F84.3 has a separate mapping under the Part D RxHCC model (HCC 133 (Anxiety and Other Psychiatric Disorders)); the applicable result needs member context. F84.3 also appears in the HHS-HCC commercial risk model (HCC 103 (HHS-HCC 103 adult, RAF varies by metal level)), where the result depends on member context and is not a Medicare Advantage payment mapping.

Code
F84.3
Description
Other childhood disintegrative disorder
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

F84.3 is the ICD-10-CM diagnosis code for other childhood disintegrative disorder. A developmental disorder where a child shows normal development for at least 2 years, then experiences a significant loss of previously acquired skills in multiple areas. F84.3 sits in the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99), within the section covering pervasive and specific developmental disorders (f80-f89).

F84.3 has no mapping under the CMS-HCC V28 or V24 community payment models. F84.3 has a separate mapping under the Part D RxHCC model (HCC 133 (Anxiety and Other Psychiatric Disorders)); the applicable result needs member context. F84.3 also appears in the HHS-HCC commercial risk model (HCC 103 (HHS-HCC 103 adult, RAF varies by metal level)), where the result depends on member context and is not a Medicare Advantage payment mapping. Do not assign V28 risk adjustment value from this page; verify the applicable model and payment year before using this code for risk adjustment.

Distinguish this from Rett syndrome (F84.2) by confirming normal development for at least 2 years before regression.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for F84.3 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Distinguish this from Rett syndrome (F84.2) by confirming normal development for at least 2 years before regression
  • •Document the specific skills lost and the timeline of deterioration

Clinical Significance

Childhood disintegrative disorder (Heller's syndrome) is a rare condition characterized by normal development for at least 2 years followed by clinically significant regression in multiple areas of functioning (language, social skills, bowel/bladder control, play, motor skills). The regression is typically more severe and later in onset than in autistic disorder. This rare condition requires extensive multidisciplinary support.

Documentation Requirements

  • ✓Provider documentation of childhood disintegrative disorder diagnosis
  • ✓Evidence of apparently normal development for at least the first 2 years of life (normal age-appropriate verbal/nonverbal communication, social relationships, play, adaptive behavior)
  • ✓Documentation of clinically significant loss of previously acquired skills in at least two areas
  • ✓Exclusion of other conditions that could account for the regression (e.g., metabolic disorders, degenerative neurological conditions)
  • ✓Current functional assessment and multidisciplinary treatment plan

Excludes 1, Do NOT code together

  • Asperger's syndrome (F84.5)
  • Autistic disorder (F84.0)
  • Rett's syndrome (F84.2)

Use Additional Code

  • code to identify any associated neurological condition.

Commonly Confused Codes

  • •F84.0: Autistic disorder; autism typically presents earlier and with less dramatic regression than CDD
  • •F84.2: Rett's syndrome; Rett also involves regression but has specific genetic (MECP2) and clinical features (hand stereotypies)
  • •G31.x: Degenerative diseases of the nervous system; neurodegenerative conditions must be ruled out
  • •F84.9: Pervasive developmental disorder, unspecified; use F84.3 when CDD is specifically documented

Child Codes

F84.0Autistic disorder
F84.2Rett's syndrome
F84.3Other childhood disintegrative disorder
F84.5Asperger's syndrome
F84.8Other pervasive developmental disorders
F84.9Pervasive developmental disorder, unspecified

Code Hierarchy

└F84Pervasive developmental disorders└F84.3Other childhood disintegrative disorder
└F84.3Other childhood disintegrative disorder

Also searched as

  • F84 3
  • F843

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