ICD-10 COVERED DIAGNOSIS TABLE - California
SPECIALTY MENTAL HEALTH OUTPATIENT SERVICES ICD-10 COVERED DIAGNOSIS TABLE
ICD-10 Diagnosis Code F20.0 F20.1 F20.2 F20.3 F20.5 F20.81 F20.89 F20.9 F21 F22 F23 F24 F25.0 F25.1
Diagnosis Description
Paranoid Schizophrenia Disorganized Schizophrenia Catatonic Schizophrenia Undifferentiated Schizophrenia Residual Schizophrenia Schizophreniform Disorder Other Schizophrenia Schizophrenia, Unspecified Schizotypal Disorder Delusional Disorder Brief Psychotic Disorder Shared Psychotic Disorder Schizoaffective Disorder, Bipolar Type
Schizoaffective Disorder, Depressive Type
F25.8 F25.9 F28
Other Schizoaffective Disorders Schizoaffective Disorder, Unspecified
Other Psychotic Disorder Not Due to a Substance or Known Physiological Condition
F29
Unspecified Psychosis Not Due to a Substance or
Known Physiological Condition
F30.10 F30.11
Manic Episode Without Psychotic Symptoms, Unspecified
Manic Episode Without Psychotic Symptoms, Mild
F30.12
Manic Episode Without Psychotic Symptoms, Moderate
F30.13
Manic Episode, Severe, Without Psychotic Symptoms
F30.2
Manic Episode, Severe, With Psychotic Symptoms
F30.3 F30.4 F30.8 F30.9 F31.0 F31.10
F31.11
F31.12
Manic Episode in Partial Remission Manic Episode in Full Remission Other Manic Episodes Manic Episode, Unspecified Bipolar Disorder, Current Episode Hypomanic Bipolar Disorder, Current Episode Manic, Without Psychotic features, Unspecified Bipolar Disorder, Current Episode Manic, Without Psychotic Features, Mild Bipolar Disorder, Current Episode Manic, Without Psychotic Features, Moderate
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SPECIALTY MENTAL HEALTH OUTPATIENT SERVICES ICD-10 COVERED DIAGNOSIS TABLE
ICD-10 Diagnosis Code F31.13
F31.2
F31.30
F31.31
Diagnosis Description
Bipolar Disorder, Current Episode Manic, Without Psychotic Features, Severe Bipolar Disorder, Current Episode Manic, Severe, With Psychotic Features Bipolar Disorder, Current Episode Depressed, Mild or Moderate Severity, Unspecified
Bipolar Disorder, Current Episode Depressed, Mild
F31.32
Bipolar Disorder, Current Episode Depressed, Moderate
F31.4 F31.5 F31.60
Bipolar Disorder, Current Episode Depressed, Severe, Without Psychotic Features Bipolar Disorder, Current Episode Depressed, Severe, With Psychotic Features
Bipolar Disorder, Current Episode Mixed, Unspecified
F31.61 F31.62
Bipolar Disorder, Current Episode Mixed, Mild Bipolar Disorder, Current Episode Mixed, Moderate
F31.63 F31.64 F31.70 F31.71 F31.72 F31.73 F31.74 F31.75 F31.76 F31.77 F31.78 F31.81 F31.89 F31.9 F32.0
Bipolar Disorder, Current Episode Mixed, Severe, Without Psychotic Features Bipolar Disorder, Current Episode Mixed, Severe, With Psychotic Features Bipolar Disorder, Currently in Remission, Most Recent Episode Unspecified Bipolar Disorder, in Partial Remission, Most Recent Episode Hypomanic Bipolar Disorder, in Full Remission, Most Recent Episode Hypomanic Bipolar Disorder, in Partial Remission, Most Recent Episode Manic Bipolar Disorder, in Full Remission, Most Recent Episode Manic Bipolar Disorder, in Partial Remission, Most Recent Episode Depressed Bipolar Disorder, in Full Remission, Most Recent Episode Depressed Bipolar Disorder, in Partial Remission, Most Recent Episode Mixed Bipolar Disorder, in Full Remission, Most Recent Episode Mixed Bipolar II Disorder Other Bipolar Disorder Bipolar Disorder, Unspecified Major Depressive Disorder, Single Episode, Mild
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SPECIALTY MENTAL HEALTH OUTPATIENT SERVICES ICD-10 COVERED DIAGNOSIS TABLE
ICD-10 Diagnosis Code F32.1
Diagnosis Description Major Depressive Disorder, Single Episode, Moderate
F32.2 F32.3 F32.4 F32.5 F32.89 F32.9
Major Depressive Disorder, Single Episode, Severe, Without Psychotic Features Major Depressive Disorder, Single Episode, Severe, With Psychotic Features Major Depressive Disorder, Single Episode, in Partial Remission Major Depressive Disorder, Single Episode, in Full Remission Other Specified Depressive Episodes
Major Depressive Disorder, Single Episode, Unspecified
F33.0 F33.1 F33.2
F33.3
F33.40
F33.41
F33.42
Major Depressive Disorder, Recurrent, Mild Major Depressive Disorder, Recurrent, Moderate Major Depressive Disorder, Recurrent, Severe, Without Psychotic Features Major Depressive Disorder, Recurrent, Severe, With Psychotic Symptoms Major Depressive Disorder, Recurrent, in Remission, Unspecified Major Depressive Disorder, Recurrent, in Partial Remission
Major Depressive Disorder, Recurrent, in Full Remission
F33.8 F33.9
Other Recurrent Depressive Disorders Major Depressive Disorder, Recurrent, Unspecified
F34.0 F34.1 F34.81 F34.89 F34.9
Cyclothymic Disorder Dysthymic Disorder Disruptive Mood Dysregulation Disorder Other Specified Persistent Mood Disorder
Persistent Mood [Affective] Disorder, Unspecified
F39 F40.00 F40.01 F40.02 F40.10 F40.11 F40.210 F40.218 F40.220 F40.228 F40.230
Unspecified Mood [Affective] Disorder Agoraphobia, Unspecified Agoraphobia With Panic Disorder Agoraphobia Without Panic Disorder Social Phobia, Unspecified Social Phobia, Generalized Arachnophobia Other Animal Type Phobia Fear of Thunderstorms Other Natural Environment Type Phobia Fear of Blood
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SPECIALTY MENTAL HEALTH OUTPATIENT SERVICES ICD-10 COVERED DIAGNOSIS TABLE
ICD-10 Diagnosis Code F40.231 F40.232 F40.233 F40.240 F40.241 F40.242 F40.243 F40.248 F40.290 F40.291 F40.298 F40.8 F41.0 F41.1 F41.3 F41.8 F41.9 F42.2 F42.3 F42.4 F42.8 F42.9 F43.0 F43.10
Diagnosis Description
Fear of Injections and Transfusions Fear of Other Medical Care Fear of Injury Claustrophobia Acrophobia Fear of Bridges Fear of Flying Other Situational Type Phobia Androphobia Gynophobia Other Specified Phobia Other Phobic Anxiety Disorders Panic Disorder Without Agoraphobia Generalized Anxiety Disorder Other Mixed Anxiety Disorders Other Specified Anxiety Disorders Anxiety Disorder, Unspecified Mixed Obsessional Thoughts and Acts Hoarding Disorder Excoriation Disorder Other Obsessive-Compulsive Disorder Obsessive-Compulsive Disorder, Unspecified Acute Stress Reaction
Post-Traumatic Stress Disorder, Unspecified
F43.11 F43.12 F43.20 F43.21
Post-Traumatic Stress Disorder, Acute Post-Traumatic Stress Disorder, Chronic Adjustment Disorder, Unspecified
Adjustment Disorder With Depressed Mood
F43.22 F43.23
F43.24
Adjustment Disorder With Anxiety Adjustment Disorder With Mixed Anxiety and Depressed Mood
Adjustment Disorder with Disturbance of Conduct
F43.25
F43.29
F44.0 F44.1 F44.4
Adjustment Disorder With Mixed Disturbance of Emotions and Conduct Adjustment Disorder With Other Symptoms Dissociative Amnesia Dissociative Fugue
Conversion Disorder With Motor Symptom or Deficit
F44.5
Conversion Disorder With Seizures or Convulsions
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SPECIALTY MENTAL HEALTH OUTPATIENT SERVICES ICD-10 COVERED DIAGNOSIS TABLE
ICD-10 Diagnosis Code F44.6
Diagnosis Description Conversion Disorder With Sensory Symptom or Deficit
F44.7
F44.81 F44.9
Conversion Disorder With Mixed Symptom Presentation Dissociative Identity Disorder
Dissociative and Conversion Disorder, Unspecified
F45.0 F45.1 F45.22 F45.41
F45.42 F45.8 F48.1
Somatization Disorder Undifferentiated Somatoform Disorder Body Dysmorphic Disorder Pain Disorder Exclusively Related to Psychological Factors Pain Disorder With Related Psychological Factors Other Somatoform Disorders
Depersonalization-Derealization Syndrome
F50.00 F50.01 F50.02
F50.2 F50.81 F50.82 F50.9 F60.0 F60.1 F60.3 F60.4 F60.5 F60.6 F60.7 F60.81 F60.9 F63.0 F63.1 F63.2 F63.3 F63.81 F63.9 F64.0 F64.2 F64.9 F65.0 F65.1 F65.2
Anorexia Nervosa, Unspecified Anorexia Nervosa, Restricting Type
Anorexia Nervosa, Binge Eating/Purging Type
Bulimia Nervosa Binge Eating Disorder Avoidant/Restrictive Food Intake Disorder Eating Disorder, Unspecified Paranoid Personality Disorder Schizoid Personality Disorder Borderline Personality Disorder Histrionic Personality Disorder Obsessive-Compulsive Personality Disorder Avoidant Personality Disorder Dependent Personality Disorder Narcissistic Personality Disorder Personality Disorder, Unspecified Pathological Gambling Pyromania Kleptomania Trichotillomania Intermittent Explosive Disorder Impulse Disorder, Unspecified Transsexualism Gender Identity Disorder of Childhood Gender Identity Disorder, Unspecified Fetishism Transvestic Fetishism Exhibitionism
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