ICD-10 Codes for Schizophrenia (F20) and Related Psychotic Disorders

Start with the words in the record. In the FY2027 Alphabetic Index, the main term "Schizophrenia, schizophrenic" points to F20.9, so a diagnosis of schizophrenia with no type stated is coded F20.9. The subterms send paranoid schizophrenia to F20.0, disorganized or hebephrenic to F20.1, catatonic to F20.2, atypical or undifferentiated to F20.3, residual to F20.5, and simple, cenesthopathic or "specified type NEC" to F20.89. There is no F20.4: the codes run from F20.3 to F20.5.

The Official Guidelines base code assignment on the provider's diagnostic statement, not on the clinical criteria the provider used (Section I.A.19), and ask for the highest level of specificity the record supports (Section IV.F.3). A subtype code is right only when the clinician documents that subtype. Category F20 also carries a "use additional code" note: when it applies, add a code from R41.84- to identify another specified cognitive deficit.

No. The APA's DSM-5 fact sheet on schizophrenia says the diagnostic criteria no longer identify subtypes, because clients' symptoms often moved from one subtype to another and overlapped, which blurred the distinctions and lowered their validity. Catatonia became a specifier that can be used with schizophrenia and with other conditions such as schizoaffective disorder, bipolar disorders and major depressive disorder. DSM-5-TR, published in 2022, is the text revision of DSM-5.

ICD-10-CM did not follow that change, so the subtype codes F20.0 to F20.5 remain valid. In practice, a record that follows DSM wording and says only "schizophrenia" is coded F20.9. Several DSM diagnosis names appear in the FY2027 tabular list as inclusion terms or in the index, which makes the mapping below traceable to the official files.

Schizoaffective disorder has its own category, F25, with four billable codes. Category F25 has an Excludes1 note for schizophrenia (F20.-) and for mood disorders with psychotic symptoms, and F20 has a matching Excludes1 note for schizoaffective disorder (F25.-) and cyclic schizophrenia (F25.0). Excludes1 means the two codes are not reported together for the same condition (Section I.A.12.a), so a record that documents schizoaffective disorder uses an F25 code instead of an F20 code.

The rest of the F20 to F29 block covers psychotic disorders that are not schizophrenia. F20 has an Excludes1 note for brief psychotic disorder and schizophrenic reaction NOS (both F23), and for mood disorders with psychotic symptoms (F30.2, F31.2, F31.5, F31.64, F32.3, F33.3). Those are coded in the bipolar and depression categories.

F20 also has an Excludes2 note for schizophrenic reaction in alcoholism (F10.15-, F10.25-, F10.95-), psychoactive drug use, brain disease or epilepsy (F06.2), and for schizotypal disorder (F21). Psychosis induced by a substance is coded in the substance category, as the substance use code guide explains.

Simple schizophrenia is coded F20.89, Other schizophrenia. "Simple schizophrenia" is an inclusion term under F20.89, and the index lists simple (type) and simplex under Schizophrenia with the same code.

There is no separate code for chronic schizophrenia. The index has no stand-alone "chronic" subterm under Schizophrenia; it sends "chronic undifferentiated" schizophrenia to F20.9, both as Schizophrenia, chronic undifferentiated and as Schizophrenia, undifferentiated, chronic. Undifferentiated schizophrenia without the word chronic is F20.3. When the record says chronic schizophrenia and nothing more, the main term applies and the code is F20.9.

The ICD-10-CM code says why the client is being seen; the CPT code says what service was provided. Therapists bill individual psychotherapy by time, such as CPT 90834 or CPT 90837, and the initial evaluation as CPT 90791. Prescribers often bill an E/M visit such as 99214, adding 90833 when they also provide psychotherapy. Which diagnoses and services a plan covers varies by payer. Confirm with the payer before billing.