ADULT MODEL, SPECIALIST COMMUNITY SETTING

Specialist community

Perinatal, memory and early-intervention-in-psychosis services — the specialist community setting band.

The clinical note

55-year-old man, referred to the Early Intervention in Psychosis (EIP) service after 12 weeks of his first psychotic episode. He reports fixed beliefs that radio programmes refer to him, low-grade hallucinations, and rapidly declining work functioning. No previous episodes, no affective predominance, negative substance screen. Attends the EIP drop-in clinic in the community; no admission required. Family and carer involvement offered. Diagnosis: paranoid schizophrenia, first episode, within 12 weeks of onset, currently untreated.

Step 1 · Routing to ICD-10-CM mental-health categories

F2098%
F232%
F010%
F020%
F030%

Step 2 · Ranking candidate codes within the top categories

F20.098%
F20.811%
F20.91%
F20.10%
F20.20%

Step 3 · The coded payment record

ICD-10-CM DIAGNOSIS
F20.0
F20.0, F20.81, F20.9 (top candidates)
PAYMENT CURRENCY · 2026/27
MAA96B
Adult - Psychosis and Bipolar Disorders - Community - Specialist (EIP)
MHNRG SECTION
Adult - Psychosis and Bipolar Disorders
diagnostic resource-group family
fields the agent extracted for this currency model
clinical needfirst-episode psychosis within 12 weeks
service/team typeEarly Intervention in Psychosis (EIP)
settingspecialist community drop-in clinic

Service report — Specialist community

currency model: Adult · specialist community setting Perinatal, memory and early-intervention-in-psychosis services share the community structure but pay under the specialist band — the team name in the note is the discriminator.

recorded fieldNELFT completeness
clinical need (diagnosis or presenting complaint)98.7%
attendance outcome invalid or unknown≥ 0.89%

The first-episode psychosis within 12 weeks was classified F20.0 (0.98) and — because the note names the Early Intervention in Psychosis service — selected the specialist community band MAA96B rather than the CMHT band MAA96A. Same diagnosis, different currency: the agent reads the distinction out of the referral line.