Alphabetic Index FY2027

F54

Psychological and behavioral factors associated with disorders or diseases classified elsewhere

FY2027Chapter 5: Mental, Behavioral and Neurodevelopmental disorders/F50–F59 Behavioral syndromes associated with physiological disturbances and physical factors

BillableComplete code, valid to report
Care settingsHospice: not accepted as primaryIPF Primary · MS-DRG 884

F54 is a billable ICD-10-CM diagnosis code for psychological and behavioral factors associated with disorders or diseases classified elsewhere. It is part of the FY2027 code set, effective October 1, 2026. The Alphabetic Index lists it under 29 entries. Its coding notes include a Code first instruction and 2 Excludes2 entries.

Code first

If the underlying condition listed here is present and known, sequence it first.

This code
  • the associated physical disorder, such as:

Excludes2

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

This code
  • tension-type headache (G44.2)
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.

Hospice: not accepted as primary

Not accepted as the principal diagnosis on a hospice claim (bill types 081x and 082x). The Integrated OCE returns an edit for this code.
Reason: Manifestation code. Report the underlying condition first (see the Code first note).

Source: CMS Integrated Outpatient Code Editor (IOCE) v27.3, effective October 1, 2026, edit 86

IPF Primary

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

MS-DRGDescriptionFactor
884Organic disturbances & intellectual disabilities1.08
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.

Source: CMS IPF PPS FY 2027 final rule (CMS-1847-F), Addendum A; code lists from the CMS MS-DRG Definitions Manual v44; 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

Inclusion terms

Conditions classified to this code.

This code
  • Psychological factors affecting physical conditions

Alphabetic Index terms

Terms the official Alphabetic Index lists for this code. 29 entries

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