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ICD-10 Guide
ICD-10 CodesF31.12

F31.12

Billable

Bipolar disorder, current episode manic without psychotic features, moderate

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

Code Description

ICD-10 F31.12 is a billable code used to indicate a diagnosis of bipolar disorder, current episode manic without psychotic features, moderate.

Key Diagnostic Point:

Bipolar disorder is a mood disorder characterized by extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). The current episode manic without psychotic features, moderate, indicates that the patient is experiencing a manic episode that is significant but does not include psychotic symptoms such as hallucinations or delusions. Symptoms of a manic episode may include increased energy, decreased need for sleep, grandiosity, talkativeness, distractibility, and involvement in high-risk activities. The moderate classification suggests that the symptoms are impactful but not severe enough to cause marked impairment in social or occupational functioning. Proper diagnosis and management are crucial, as untreated manic episodes can lead to severe consequences, including increased risk of suicide and harm to self or others. Treatment typically involves mood stabilizers, antipsychotic medications, and psychotherapy, with a focus on managing symptoms and preventing future episodes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between manic and hypomanic episodes
  • Assessing severity of the episode
  • Identifying absence of psychotic features
  • Documenting the impact on functioning

Audit Risk Factors

  • Inadequate documentation of symptoms
  • Failure to specify the severity of the episode
  • Misclassification of manic vs. hypomanic episodes
  • Lack of evidence for absence of psychotic features

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Comprehensive mental status examination, detailed history of mood episodes, and treatment response.

Common Clinical Scenarios

Initial diagnosis of bipolar disorder, management of acute manic episodes, and medication adjustments.

Billing Considerations

Ensure clear documentation of the absence of psychotic features and the impact on daily functioning.

Primary Care

Documentation Requirements

Screening for mood disorders, referral notes to psychiatry, and follow-up on treatment adherence.

Common Clinical Scenarios

Monitoring patients with known bipolar disorder, managing comorbid conditions, and coordinating care.

Billing Considerations

Documenting any changes in mood or behavior that may indicate a shift in the patient's condition.

Coding Guidelines

Inclusion Criteria

Use F31.12 When
  • According to ICD
  • 10 guidelines, F31
  • 12 should be used when the patient is currently experiencing a manic episode that is moderate in severity and does not include psychotic features
  • Documentation must support the diagnosis, including symptom severity and duration

Exclusion Criteria

Do NOT use F31.12 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99214CPT Code

Established patient office visit, level 4

Clinical Scenario

Used for follow-up visits for patients with bipolar disorder experiencing manic episodes.

Documentation Requirements

Document the patient's mood, functioning, and any changes in treatment.

Specialty Considerations

Psychiatrists may require more detailed mental status exams.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of bipolar disorder, improving the ability to capture the nuances of the condition, such as the presence or absence of psychotic features and the severity of episodes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of bipolar disorder, improving the ability to capture the nuances of the condition, such as the presence or absence of psychotic features and the severity of episodes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of bipolar disorder, improving the ability to capture the nuances of the condition, such as the presence or absence of psychotic features and the severity of episodes.

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 distinguishes F31.12 from other bipolar disorder codes?

F31.12 specifically indicates a current manic episode that is moderate in severity and does not include psychotic features, which is crucial for treatment planning and management.