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ICD-10 Guide
ICD-10 CodesF31.64

F31.64

Billable

Bipolar disorder, current episode mixed, severe, with psychotic features

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

Code Description

ICD-10 F31.64 is a billable code used to indicate a diagnosis of bipolar disorder, current episode mixed, severe, with psychotic features.

Key Diagnostic Point:

F31.64 refers to a severe mixed episode of bipolar disorder characterized by the simultaneous presence of manic and depressive symptoms. This condition can manifest with significant mood instability, where the patient experiences both elevated and depressed moods concurrently. Psychotic features may include hallucinations or delusions, which can complicate the clinical picture and require careful management. Patients may exhibit extreme irritability, agitation, and impulsivity, alongside feelings of hopelessness or worthlessness. The presence of psychotic features necessitates a comprehensive treatment approach, often involving mood stabilizers, antipsychotics, and psychotherapy. The risk of suicide is notably elevated in this population, making thorough risk assessment and safety planning essential components of care. Accurate diagnosis and coding are critical for appropriate treatment and reimbursement, as well as for tracking the prevalence and outcomes of this serious mental health condition.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Presence of mixed symptoms complicates diagnosis.
  • Psychotic features require additional documentation.
  • Differentiation from other mood disorders is necessary.
  • Severity assessment impacts treatment planning.

Audit Risk Factors

  • Inadequate documentation of psychotic features.
  • Failure to assess and document suicide risk.
  • Misclassification of episode severity.
  • Lack of comprehensive treatment plans.

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed psychiatric evaluations, including mental status exams and risk assessments.

Common Clinical Scenarios

Patients presenting with acute manic and depressive symptoms, requiring hospitalization.

Billing Considerations

Documentation must clearly outline the presence of psychotic features and their impact on treatment.

Primary Care

Documentation Requirements

Thorough history and physical examination, including mental health screenings.

Common Clinical Scenarios

Patients with known bipolar disorder presenting with acute mood changes.

Billing Considerations

Coordination with mental health specialists for comprehensive care.

Coding Guidelines

Inclusion Criteria

Use F31.64 When
  • According to ICD
  • 10 guidelines, F31
  • 64 should be used when the patient is currently experiencing a mixed episode that is severe and includes psychotic features
  • Documentation must support the diagnosis, including the presence of both manic and depressive symptoms and any psychotic manifestations

Exclusion Criteria

Do NOT use F31.64 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

90837CPT Code

Psychotherapy, 60 minutes with patient

Clinical Scenario

Used for ongoing therapy sessions with patients diagnosed with F31.64.

Documentation Requirements

Session notes must detail the therapeutic interventions and patient progress.

Specialty Considerations

Psychiatrists should document the severity of symptoms and treatment response.

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, including the differentiation of mixed episodes and the inclusion of psychotic features, which enhances the accuracy of treatment tracking and reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of bipolar disorder, including the differentiation of mixed episodes and the inclusion of psychotic features, which enhances the accuracy of treatment tracking and reimbursement.

Reimbursement & Billing Impact

reimbursement.

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 are the key symptoms of F31.64?

Key symptoms include simultaneous manic and depressive episodes, severe mood instability, and the presence of psychotic features such as hallucinations or delusions.