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ICD-10 Guide
ICD-10 CodesF25.0

F25.0

Billable

Schizoaffective disorder, bipolar type

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 F25.0 is a billable code used to indicate a diagnosis of schizoaffective disorder, bipolar type.

Key Diagnostic Point:

Schizoaffective disorder, bipolar type is a mental health condition characterized by the presence of both mood disorder symptoms (such as mania or depression) and symptoms of schizophrenia (such as hallucinations or delusions). This disorder can significantly impair an individual's ability to function in daily life. The mood episodes can occur concurrently with the psychotic symptoms or can precede or follow them. Diagnosis requires a careful assessment of the duration and severity of symptoms, ensuring that the mood disorder is prominent and that psychotic symptoms are not solely attributable to a mood episode. Treatment typically involves a combination of antipsychotic medications, mood stabilizers, and psychotherapy. The complexity of this disorder lies in its overlapping symptoms with other mental health conditions, necessitating thorough clinical evaluation and ongoing monitoring to tailor treatment effectively.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Overlap of symptoms with other psychiatric disorders
  • Variability in presentation and severity of symptoms
  • Need for comprehensive documentation of mood episodes
  • Potential for misdiagnosis with schizophrenia or bipolar disorder

Audit Risk Factors

  • Inadequate documentation of mood episodes
  • Failure to differentiate from schizophrenia or bipolar disorder
  • Lack of evidence for ongoing treatment and management
  • Inconsistent use of diagnostic criteria

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed clinical notes on symptomatology, treatment plans, and patient progress.

Common Clinical Scenarios

Initial diagnosis, medication management, and therapy sessions.

Billing Considerations

Ensure clear documentation of both mood and psychotic symptoms to support the diagnosis.

Psychology

Documentation Requirements

Psychological assessments, therapy notes, and progress evaluations.

Common Clinical Scenarios

Therapeutic interventions and psychological evaluations.

Billing Considerations

Document the impact of symptoms on functioning and any co-occurring disorders.

Coding Guidelines

Inclusion Criteria

Use F25.0 When
  • According to ICD
  • 10 guidelines, F25
  • 0 should be used when the patient exhibits both mood disorder symptoms and psychotic symptoms
  • It is essential to document the duration and severity of both sets of symptoms to meet diagnostic criteria

Exclusion Criteria

Do NOT use F25.0 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

90837CPT Code

Psychotherapy, 60 minutes with patient

Clinical Scenario

Used during therapy sessions for patients diagnosed with F25.0.

Documentation Requirements

Document the duration of the session and the focus of therapy.

Specialty Considerations

Psychiatrists should ensure that therapy aligns with the treatment plan for schizoaffective disorder.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of mental health disorders, including schizoaffective disorder, which aids in better tracking and treatment planning.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of mental health disorders, including schizoaffective disorder, which aids in better tracking and treatment planning.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of mental health disorders, including schizoaffective disorder, which aids in better tracking and treatment planning.

Resources

Clinical References

  • •
    American Psychiatric Association - Diagnostic and Statistical Manual of Mental Disorders

Coding & Billing References

  • •
    American Psychiatric Association - Diagnostic and Statistical Manual of Mental Disorders

Frequently Asked Questions

What is the difference between schizoaffective disorder and schizophrenia?

Schizoaffective disorder includes mood disorder symptoms alongside psychotic symptoms, while schizophrenia primarily involves psychotic symptoms without significant mood disturbances.