ICD-10 F28: Other psychotic disorder not due to a substance or known physiological condition
Formerly DSM-5 298.8 — Other Specified Schizophrenia Spectrum and Other Psychotic Disorder. Both codes describe the same diagnosis; ICD-10 F28 is the one an insurer expects on a superbill.
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ICD-10 code F28 (Other psychotic disorder not due to a substance or known physiological condition) is a schizophrenia spectrum code used on superbills for mental health therapy billing. Insurance companies require at least one ICD-10 code per superbill to process a reimbursement claim.
CPT Codes Commonly Used With F28
Common CPT codes paired with ICD-10 F28 include 90837 (60-min psychotherapy), 90834 (45-min psychotherapy), and 90791 (initial psychiatric evaluation). The CPT code reflects the service rendered, not the diagnosis.
Clinical Criteria
Psychotic presentations not meeting criteria for schizophrenia, schizoaffective disorder, schizophreniform disorder, brief psychotic disorder, or delusional disorder. Not attributable to substance use or medical conditions. Includes persistent auditory hallucinations in sane persons.
DSM-5 Cross-Reference
DSM-5 298.8 — Other Specified Schizophrenia Spectrum and Other Psychotic Disorder
Common CPT Pairings
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