Alphabetic Index FY2027

F45.42

Pain disorder with related psychological factors

FY2027Chapter 5: Mental, Behavioral and Neurodevelopmental disorders/F40–F48 Anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders

BillableComplete code, valid to report
Care settingsHome Health Primary · Behavioral HealthIPF Primary · MS-DRG 882

F45.42 (also written F4542) is a billable ICD-10-CM diagnosis code for pain disorder with related psychological factors. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 10 codes in category F45 (Somatoform disorders). The Alphabetic Index lists it under 1 entry. Its coding notes include a Code also instruction, 1 Excludes1 entry and 14 Excludes2 entries.

Guidelines tip

From the FY2027 Official Guidelines. ICD10Ref adds no rules of its own.

F45.41 is for pain exclusively related to psychological disorders and is not used with G89. F45.42 is used with a G89 code when a psychological component is documented.

Guidelines I.C.5.aPain disorders related to psychological factorsRead the official text

Code also

Two codes may be needed to describe the condition. This note gives no sequencing order.

This code
  • associated acute or chronic pain (G89.-)

Excludes1

Not coded here. The listed conditions generally should not be reported together.

Inherited from F45.4 Pain disorders related to psychological factors

Excludes2

Not included here. Both codes may be reported if the patient has both conditions.

Inherited from F45 Somatoform disorders
  • dissociative and conversion disorders (F44.-)
  • factitious disorders (F68.1-, F68.A)
  • hair-plucking (F63.3)
  • lalling (F80.0)
  • lisping (F80.0)
  • malingering [conscious simulation] (Z76.5)
  • nail-biting (F98.8)
  • psychological or behavioral factors associated with disorders or diseases classified elsewhere (F54)
  • sexual dysfunction, not due to a substance or known physiological condition (F52.-)
  • thumb-sucking (F98.8)
  • tic disorders (in childhood and adolescence) (F95.-)
  • Tourette's syndrome (F95.2)
  • trichotillomania (F63.3)
Also from chapter/block level (1 note)
Inherited from Chapter 5 Mental, Behavioral and Neurodevelopmental disorders
  • symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99)

Care settings

How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.

Home Health Primary

Accepted as the primary (principal) diagnosis on a home health claim. The Home Health Grouper assigns it to the Behavioral Health clinical group.

Source: CMS Home Health Grouper Software v07.2.26, effective October 1, 2026

IPF Primary

IPF MS-DRG adjustment. A principal diagnosis of this code groups to this MS-DRG:

MS-DRGDescriptionFactor
882Neuroses except depressive1.02
A principal diagnosis that groups to none of the 19 designated MS-DRGs gets no MS-DRG adjustment. Otherwise the claim still receives the federal per diem base rate and the other adjustments. This code is on the CMS IPF Code First table with the instruction “Code also associated acute or chronic pain” (see the Code also note).

Source: CMS IPF PPS FY 2027 final rule (CMS-1847-F), Addendum A; code lists from the CMS MS-DRG Definitions Manual v44, Addendum B-2 (Code First table); effective for discharges on or after October 1, 2026

Includes

Further defines or gives examples of the content of the category.

Also from chapter/block level (1 note)
Inherited from Chapter 5 Mental, Behavioral and Neurodevelopmental disorders
  • disorders of psychological development

Alphabetic Index terms

Terms the official Alphabetic Index lists for this code. 1 entry