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2025 ICD-10-CM code F06.0

Psychotic disorder with hallucinations due to a known physiological condition.

Code the underlying physiological condition first. This code should not be used if the hallucinations are due to substance use or other mental health disorders like schizophrenia.

Medical necessity is established by the presence of a documented physiological condition causing the psychotic disorder with hallucinations. The medical record should demonstrate a clear causal link between the physical condition and the mental health symptoms.

Clinicians diagnose this condition based on patient history, symptoms, physical and neuropsychological exams. Interviews with family or caregivers can help clarify symptoms. Lab tests, CT scans, MRI, and EEG may be used for diagnosis. Treatment focuses on the underlying cause and might include antipsychotic medication and supportive care.

In simple words: This condition involves experiencing things that aren't real (hallucinations) due to a physical problem affecting the brain.It's important to identify and treat the underlying physical cause.

A group of mental symptoms characterized by a loss of contact with reality, particularly hallucinations, caused by demonstrable brain damage or dysfunction due to a physical disease. The underlying physiological condition should be coded first.

Example 1: A patient with a history of stroke experiences visual hallucinations., A patient with a brain tumor develops auditory hallucinations and disorganized speech., A patient with epilepsy experiences tactile hallucinations before a seizure.

Documentation should clearly link the psychotic symptoms, specifically hallucinations, to a known physiological condition. Details of the underlying condition, onset of symptoms, and any diagnostic tests (e.g., CT, MRI, EEG) should be included. The type of hallucination (visual, auditory, tactile, etc.) should also be documented.

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