ICD-10 Codes for OCD: F42.9, F42.2 and Related Codes
Codes verified against the CMS FY2027 ICD-10-CM code descriptions (effective October 1, 2026; these codes are unchanged from FY2026). Reviewed . See sources.
What is the ICD-10 code for OCD?
The ICD-10-CM code for obsessive-compulsive disorder is F42.9, Obsessive-compulsive disorder, unspecified, which is where the Alphabetic Index sends "Disorder, obsessive-compulsive." F42.2 is mixed obsessional thoughts and acts, F42.3 is hoarding disorder, F42.4 is excoriation disorder, and F42.8 is other obsessive-compulsive disorder. F42 alone is a heading.
Category F42, Obsessive-compulsive disorder, sits in Chapter 5 of ICD-10-CM between the anxiety disorders (F41) and the stress-related disorders (F43). It has five billable codes. Which one fits depends on how the treating clinician has documented the diagnosis, not on the symptoms alone.
This page lists each F42 code with its official FY2027 description, explains the Excludes notes and inclusion terms in the tabular list, and shows what a session note should contain so the diagnosis is supported. For the anxiety side of the chapter, see the anxiety codes guide.
F42 obsessive-compulsive disorder codes
| Code | Official description (FY2027) | Billable | When it fits |
|---|---|---|---|
| F42 | Obsessive-compulsive disorder | No (header) | Category only. Pick a billable code below. |
| F42.2 | Mixed obsessional thoughts and acts | Yes | The record documents both obsessional thoughts and compulsive acts. |
| F42.3 | Hoarding disorder | Yes | Documented hoarding disorder. |
| F42.4 | Excoriation (skin-picking) disorder | Yes | Documented excoriation disorder. Excludes1 note for factitial dermatitis (L98.1). |
| F42.8 | Other obsessive-compulsive disorder | Yes | Inclusion terms: anancastic neurosis, obsessive-compulsive neurosis. |
| F42.9 | Obsessive-compulsive disorder, unspecified | Yes | Obsessive-compulsive disorder without more detail. The Alphabetic Index entry "Disorder, obsessive-compulsive" points here. |
Which F42 code fits the diagnosis?
Start with the diagnosis in the record. The FY2027 Alphabetic Index lists "Disorder, obsessive-compulsive" at F42.9, so a record that says only "obsessive-compulsive disorder" leads to F42.9. When the clinician documents a more specific presentation, the tabular list offers a closer match: F42.2 for mixed obsessional thoughts and acts, F42.3 for hoarding disorder, and F42.4 for excoriation (skin-picking) disorder.
The Index also lists "Obsessive-compulsive neurosis or reaction" at F42.8, and the F42.8 inclusion terms are anancastic neurosis and obsessive-compulsive neurosis. The Official Guidelines say to locate the term in the Alphabetic Index and then verify the code in the Tabular List (Section I.B.1), and to code to the highest level of specificity the record supports (Section IV.F.3). F42.9 is a valid code, but a more specific F42 code is better once the documentation supports one.
What do the F42 Excludes notes mean?
Category F42 carries an Excludes2 note for obsessive-compulsive personality disorder (F60.5), obsessive-compulsive symptoms occurring in depression (F32.-, F33.-), and obsessive-compulsive symptoms occurring in schizophrenia (F20.-). The Official Guidelines define Excludes2 as "not included here": the excluded condition is not part of the F42 code, but a client may have both, so both codes can be reported when both are documented.
F42.4 has an Excludes1 note for factitial dermatitis (L98.1) and for other specified behavioral and emotional disorders with onset usually occurring in early childhood and adolescence (F98.8). Excludes1 means the code excluded should never be reported at the same time, unless the two conditions are unrelated to each other (Section I.A.12.a). If it is unclear whether they are related, the guidelines say to query the provider.
Which codes are easy to confuse with F42?
These are the codes that most often sit next to an F42 code in a record:
| Code | Official description (FY2027) | Billable | When it fits |
|---|---|---|---|
| F60.5 | Obsessive-compulsive personality disorder | Yes | A personality disorder, not OCD. Listed in the F42 Excludes2 note. |
| F41.1 | Generalized anxiety disorder | Yes | Neither F41 nor F42 lists the other in an Excludes note, so both can be reported when both are documented. |
| R46.81 | Obsessive-compulsive behavior | Yes | Symptom code. The Index lists "Behavior, obsessive-compulsive" here. For use when no diagnosis is established (Section I.B.4). Excludes1 note for obsessive-compulsive disorder (F42.-). |
| L98.1 | Factitial dermatitis | Yes | Named in the F42.4 Excludes1 note. |
| F98.8 | Other specified behavioral and emotional disorders with onset usually occurring in childhood and adolescence | Yes | Named in the F42.4 Excludes1 note. |
Can I code "rule out OCD" or a provisional diagnosis?
Not in an outpatient setting. Section IV.H of the FY2027 guidelines says not to code diagnoses documented as probable, suspected, questionable, rule out, compatible with, consistent with, or working diagnosis. Code the condition to the highest degree of certainty for that visit instead, such as the symptoms. R46.81, Obsessive-compulsive behavior, is a billable symptom code. This differs from the rules used by short-term acute care, long-term care and psychiatric hospitals.
Once the evaluation confirms a diagnosis, update the code on later claims. The treatment plan template is a good place to record the confirmed diagnosis and the goals it drives.
How does the OCD code connect to the CPT code?
The ICD-10-CM code says why the client is being seen; the CPT code says what service was provided. A 53 minute individual session for a client with a documented F42.9 diagnosis is reported as CPT 90837 with F42.9 as the diagnosis, and the initial evaluation is reported with CPT 90791. The diagnosis must be supported in the note for every date of service, not only at intake.
What should the session note show?
- The diagnosis in words, as the treating clinician states it (for example "obsessive-compulsive disorder"), matching the code on the claim. The Official Guidelines base code assignment on the provider's diagnostic statement (Section I.A.19).
- Which presentation is documented: obsessional thoughts, compulsive acts, or both. F42.2 describes both together.
- Current symptoms observed or reported this session, how often they occur, and how much of the client's day they take.
- Functional impact: work, school, relationships, or daily routines affected by the symptoms or by avoidance.
- Any measure used, with the instrument named and the date given.
- The intervention used, the client's response, and progress toward a treatment plan goal.
- Draft the session note in SOAP or DAP format so symptoms, assessment and plan sit in predictable places.
Common mistakes
- Reporting F42 without a fourth character. F42 is a category heading, so the claim is invalid.
- Using F42.2 only because it is the code most pages list, when the record documents obsessive-compulsive disorder without a stated presentation.
- Reporting F42.4 together with L98.1 for the same skin condition despite the Excludes1 note.
- Coding "rule out OCD" as F42.9 on an outpatient claim instead of coding the documented symptoms.
- Billing F60.5 when the record documents OCD, or the reverse. They are different conditions.
- A diagnosis on the claim that never appears in the session note.
Frequently Asked Questions
What is the ICD-10 code for OCD?
F42.9, Obsessive-compulsive disorder, unspecified, is the code the FY2027 Alphabetic Index lists for "Disorder, obsessive-compulsive." More specific codes are F42.2 (mixed obsessional thoughts and acts), F42.3 (hoarding disorder), F42.4 (excoriation disorder) and F42.8 (other obsessive-compulsive disorder).
Is F42.2 the ICD-10 code for OCD?
F42.2 is titled Mixed obsessional thoughts and acts. It fits when the record documents both obsessional thoughts and compulsive acts. When the record says only obsessive-compulsive disorder, the Alphabetic Index points to F42.9.
What is the ICD-10 code for hoarding disorder?
F42.3, Hoarding disorder. It is billable in FY2027 ICD-10-CM and sits in category F42 with the other obsessive-compulsive disorder codes.
What is the ICD-10 code for excoriation (skin-picking) disorder?
F42.4, Excoriation (skin-picking) disorder. It has an Excludes1 note for factitial dermatitis (L98.1), so those two codes are not reported together for the same condition.
Can OCD and anxiety be coded together?
Yes, when the clinician documents both. Neither the F42 category nor the F41 category lists the other in an Excludes note, so there is no coding rule that blocks reporting both.
Is F42 a billable code?
No. F42 is a category heading. The billable codes are F42.2, F42.3, F42.4, F42.8 and F42.9, because a code is invalid if it lacks the full number of characters required (Official Guidelines Section IV.F.2).
Did the OCD codes change for FY2027?
No. The FY2027 addenda list no additions, deletions or description changes for category F42. FY2027 took effect October 1, 2026.
Related references
Sources
- CMS: FY2027 ICD-10-CM code descriptions in tabular order (zip)
- CMS: FY2027 ICD-10-CM code tables, tabular and index (zip)
- CMS and NCHS: ICD-10-CM Official Guidelines for Coding and Reporting, FY2027 (PDF)
- CMS: ICD-10 code files (FY2027 and FY2026 ICD-10-CM)
- CDC NCHS: ICD-10-CM and the ICD-10-CM Browser Tool
Payer rules vary. Confirm diagnosis, coverage, modifier, and documentation rules with each payer before billing. This page is general education, not billing, coding, or legal advice. The diagnosis is the treating clinician's decision.
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