ICD-10 · PDGM grouping
F06 Other mental disorders due to known physiological condition
All 12 codes in the F06 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
12
Can lead a claim
0
Cannot lead a claim
12
What CMS assigns to F06
None of the 12 codes is assigned a clinical group. 4 of the 12 count toward the Psychotic, major depressive, and dissociative disorders, includes unspecified dementia, eating disorder and intellectual disabilities comorbidity subgroup; 8 are assigned none. None can lead a claim. CMS attaches a code-first note to all 12.
- 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 12, on F06.0, F06.1, F06.2, F06.30, F06.31, F06.32, F06.33, F06.34, F06.4, F06.8. Code first:
- underlying disease
CMS grouper convention 27, on F06.70, F06.71. Code first:
- Alzheimer's disease (G30.-)
- Huntington's disease (G10)
- Neurocognitive disorder with Lewy bodies (G31.83)
- Parkinson's disease (G20.-)
- human immunodeficiency virus [HIV] disease (B20)
- other frontotemporal neurocognitive disorder (G31.09)
- systemic lupus erythematosus (M32.-)
- the underlying physiological condition
- the underlying physiological condition, such as:
- traumatic brain injury (S06.-)
- vitamin B deficiency (E53.-)
Every code in F06
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 |
|---|---|---|---|---|
| F06.0 | Psychotic disorder with hallucinations due to known physiological conditionCMS: Psychotic disorder w hallucin due to known physiol condition | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| F06.1 | Catatonic disorder 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 |
| F06.2 | Psychotic disorder with delusions due to known physiological conditionCMS: Psychotic disorder w delusions due to known physiol cond | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| F06.3 Mood disorder due to known physiological condition | ||||
| F06.30 | Mood disorder due to known physiological condition, unspecifiedCMS: Mood disorder due to known physiological condition, unsp | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| F06.31 | Mood disorder due to known physiological condition with depressive featuresCMS: Mood disorder due to known physiol cond w depressv features | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| F06.32 | Mood disorder due to known physiological condition with major depressive-like episodeCMS: Mood disord d/t physiol cond w major depressive-like epsd | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| F06.33 | Mood disorder due to known physiological condition with manic featuresCMS: Mood disorder due to known physiol cond w manic features | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| F06.34 | Mood disorder due to known physiological condition with mixed featuresCMS: Mood disorder due to known physiol cond w mixed features | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| F06.4 | Anxiety disorder due to known physiological condition | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| F06.7 Mild neurocognitive disorder due to known physiological condition | ||||
| F06.70 | Mild neurocognitive disorder due to known physiological condition without behavioral disturbanceCMS: Mild neurocog disord d/t known physiol cond w/o beh distrb | Cannot lead a claimUnacceptable principal diagnosis, code is not reportable as principal diagnosis | None | Psychotic, major depressive, and dissociative disorders, includes unspecified dementia, eating disorder and intellectual disabilities |
| F06.71 | Mild neurocognitive disorder due to known physiological condition with behavioral disturbanceCMS: Mild neurocog disord d/t known physiol cond with beh distrb | Cannot lead a claimUnacceptable principal diagnosis, code is not reportable as principal diagnosis | None | Psychotic, major depressive, and dissociative disorders, includes unspecified dementia, eating disorder and intellectual disabilities |
| F06.8 | Other specified mental disorders due to known physiological conditionCMS: Oth mental disorders 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.
The monthly home health regs digest
What CMS changed, what's due next, and what to do about it — one email a month, no fluff. Read the first issue