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    v1.0.28
    OpenPayerBilling CodesSchizophrenia, schizotypal, delusional, and other non-mood psychotic disordersICD-10-CM f28-other-psychotic-disorder
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    ICD-10-CM Code For Other Psychotic Disorder Not Due To A Substance Or Known Physiological Condition: Group Overview

    The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group F28 includes atypical or residual psychotic disorders and other non-mood psychoses that are not due to substance use or a specified physiological condition, covering persistent psychotic symptoms such as delusions and hallucinations without criteria for another specific psychotic disorder. These ICD-10-CM diagnosis codes are used to document clinical encounters where primary psychotic symptoms are present, capturing disease severity, symptom persistence, and clinical complexity relevant to mental health management. Accurate coding within the ICD-10-CM F28 group supports proper claim adjudication, complete clinical documentation, and appropriate reimbursement.

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    ICD-10-CM F28: Other Psychotic Disorder Not Due To A Substance Or Known Physiological Condition Overview

    The diagnoses in this group represent primary psychotic disorders characterized by delusions, hallucinations, disorganized thought, or other psychotic symptoms not attributable to substance use or a known physiological condition. These conditions affect mental and behavioral functioning and may involve acute or chronic psychotic symptoms. Accurate coding ensures the clinical picture is clearly documented and supports appropriate reimbursement and care coordination.

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    When to Use

    Use a code from this group when a patient presents with primary psychotic symptoms and the clinician determines these are not caused by substances or an identifiable physiological condition. These codes apply when psychotic features are present but do not fit the diagnostic criteria for another defined psychotic disorder category.

    ICD-10-CM Codes

    1 rows

    ICD-10-CM CodeDescription
    F28Other psychotic disorder not due to a substance or known physiological condition

    DRG Codes

    4 rows

    DRG CodeDescription
    885Psychoses
    974HIV with Major Related Condition with MCC
    975HIV with Major Related Condition with CC
    976HIV with Major Related Condition without CC/MCC

    Typical Clinical Scenarios

    • A 28-year-old adult presents to the outpatient psychiatry clinic with a two-year history of persistent, non-bizarre paranoid beliefs and auditory hallucinations that do not meet criteria for schizophrenia (symptoms are less severe and without marked functional decline). The patient reports long-standing odd thinking and social withdrawal, with symptoms causing occupational difficulties but without clear substance use or a medical cause after evaluation; a diagnosis from this group is assigned when psychotic symptoms are present yet do not fit other specific psychotic disorder categories. Typical codes: F28
    • An older adult is brought to the emergency department by family for new-onset visual hallucinations and persecutory delusions developing gradually over months, with primary medical workup (including toxicology, metabolic panel, and neuroimaging) unrevealing for a physiological cause; the patient is distressed but medically stable. Because psychosis persists and is not attributable to substances, delirium, or a neurocognitive disorder based on assessment, a code from this group is used for the acute evaluation and initial management. Typical codes: F28
    • A 35-year-old with a chronic psychiatric history presents for routine follow-up for treatment-resistant psychotic symptoms that have persisted despite trials of antipsychotics and do not conform to schizoaffective or delusional disorder diagnoses; the clinician documents ongoing hallucinations, disorganized thought, and functional impairment without an identifiable organic etiology. The persistent, non-substance-related psychosis that does not meet criteria for other specific psychotic disorders is coded from this category for longitudinal care planning and monitoring. Typical codes: F28

    Related Codes

    F20-SCHIZOPHRENIA

    ICD-10-CM Code For Schizophrenia: Group Overview

    F21-SCHIZOTYPAL-DISORDER

    ICD-10-CM Code For Schizotypal Disorder: Group Overview

    F22-DELUSIONAL-DISORDERS

    ICD-10-CM Code For Delusional Disorders: Group Overview

    F23-BRIEF-PSYCHOTIC-DISORDER

    ICD-10-CM Code For Brief Psychotic Disorder: Group Overview

    F24-SHARED-PSYCHOTIC-DISORDER

    ICD-10-CM Code For Shared Psychotic Disorder: Group Overview

    F25-SCHIZOAFFECTIVE-DISORDERS

    ICD-10-CM Code For Schizoaffective Disorders: Group Overview

    F29-UNSPECIFIED-PSYCHOSIS-NOT-DUE-TO-A-SUBSTANCE

    ICD-10-CM Code For Unspecified Psychosis Not Due To A Substance Or Known Physiological Condition: Group Overview

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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