ICD-10 · PDGM grouping
F05 Delirium due to known physiological condition
The one code in the F05 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
1
Can lead a claim
0
Cannot lead a claim
1
What CMS assigns to F05
This code is assigned no clinical group. It counts toward the Psychotic, major depressive, and dissociative disorders, includes unspecified dementia, eating disorder and intellectual disabilities comorbidity subgroup. It cannot lead a claim. CMS attaches a code-first note to it.
- Psychotic, major depressive, and dissociative disorders, includes unspecified dementia, eating disorder and intellectual disabilities: counts toward the high comorbidity tier only in an interaction pair.
Code first
CMS grouper convention 26. Code first:
- dementia (F03.9-)
- the underlying physiological condition, such as:
The F05 code
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| F05 | Delirium due to known physiological condition | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | Psychotic, major depressive, and dissociative disorders, includes unspecified dementia, eating disorder and intellectual disabilities |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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