ICD-10 · PDGM grouping
F07 Personality and behavioral disorders due to known physiological condition
All 4 codes in the F07 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
4
Can lead a claim
0
Cannot lead a claim
4
What CMS assigns to F07
None of the 4 codes is assigned a clinical group. 3 of the 4 count toward the Psychotic, major depressive, and dissociative disorders, includes unspecified dementia, eating disorder and intellectual disabilities comorbidity subgroup; 1 is assigned none. None can lead a claim. CMS attaches a code-first note to all 4.
- 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 all 4 codes. Code first:
- underlying disease
Every code in F07
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 |
|---|---|---|---|---|
| F07.0 | Personality change due to known physiological condition | 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 |
| F07.8 Other personality and behavioral disorders due to known physiological condition | ||||
| F07.81 | Postconcussional syndrome | 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 |
| F07.89 | Other personality and behavioral disorders due to known physiological conditionCMS: Oth personality & behavrl disord due to known physiol cond | 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 |
| F07.9 | Unspecified personality and behavioral disorder due to known physiological conditionCMS: Unsp personality & behavrl disord due to known physiol cond | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
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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