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ICD-10 Guide
ICD-10 CodesF25.1

F25.1

Billable

Schizoaffective disorder, depressive type

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

Code Description

ICD-10 F25.1 is a billable code used to indicate a diagnosis of schizoaffective disorder, depressive type.

Key Diagnostic Point:

Schizoaffective disorder, depressive type, is a mental health condition characterized by the presence of both mood disorder symptoms (specifically depressive episodes) and symptoms of schizophrenia. Patients may experience delusions, hallucinations, disorganized thinking, and significant mood disturbances, which can include persistent sadness, loss of interest in activities, and feelings of worthlessness. The depressive episodes must occur concurrently with the psychotic symptoms, and the duration of these symptoms must be significant enough to impair social and occupational functioning. Diagnosis requires careful clinical assessment to differentiate schizoaffective disorder from other mood disorders and schizophrenia, as well as to rule out substance-induced psychotic disorders. Treatment typically involves a combination of antipsychotic medications, mood stabilizers, and psychotherapy, focusing on managing both the psychotic and mood symptoms to improve overall functioning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between schizoaffective disorder and other mood disorders or schizophrenia.
  • The need for comprehensive documentation of both mood and psychotic symptoms.
  • Variability in symptom presentation among patients.
  • Potential overlap with substance-induced psychotic disorders.

Audit Risk Factors

  • Inadequate documentation of symptom duration.
  • Failure to differentiate from other mood disorders.
  • Lack of evidence for functional impairment.
  • Misclassification of depressive episodes as primary mood disorders.

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

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

Common Clinical Scenarios

Initial diagnosis, treatment adjustments, and follow-up assessments.

Billing Considerations

Ensure clarity in distinguishing between schizoaffective disorder and other psychotic disorders.

Psychology

Documentation Requirements

Psychological assessments and therapy notes detailing mood and psychotic symptoms.

Common Clinical Scenarios

Therapeutic interventions and progress evaluations.

Billing Considerations

Collaboration with psychiatrists for medication management.

Coding Guidelines

Inclusion Criteria

Use F25.1 When
  • According to ICD
  • 10 guidelines, F25
  • 1 should be used when a patient exhibits both depressive symptoms and psychotic features
  • Documentation must support the diagnosis, including the duration and severity of symptoms

Exclusion Criteria

Do NOT use F25.1 When
  • Exclusion criteria include primary mood disorders without psychotic features

Related ICD-10 Codes

Related CPT Codes

90834CPT Code

Psychotherapy, 45 minutes with patient

Clinical Scenario

Used during therapy sessions for patients diagnosed with F25.1.

Documentation Requirements

Document the duration and focus of therapy sessions.

Specialty Considerations

Psychiatrists may also use this code for medication management sessions.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of schizoaffective disorders, improving the accuracy of diagnoses and treatment plans. This specificity aids in better tracking of treatment outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of schizoaffective disorders, improving the accuracy of diagnoses and treatment plans. This specificity aids in better tracking of treatment outcomes and resource allocation.

Reimbursement & Billing Impact

impact on functioning are clearly documented.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What distinguishes schizoaffective disorder from schizophrenia?

Schizoaffective disorder includes both mood disorder symptoms and psychotic features, whereas schizophrenia primarily involves psychotic symptoms without significant mood disturbances.