2025 ICD-10-CM code F31.64
Bipolar disorder, current episode mixed, severe, with psychotic features.
Medical necessity for this code requires that the patient's symptoms meet the diagnostic criteria for bipolar I disorder, current episode mixed, severe, with psychotic features as defined in the DSM-5. The documentation should clearly demonstrate the presence of both manic and depressive symptoms concurrently, as well as psychotic features, and how these symptoms significantly impair the individual's functioning in daily life, requiring medical intervention.
Clinicians diagnose bipolar disorder based on patient history, symptoms, and behavioral observation, often using criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Treatment may include medication (mood stabilizers, antidepressants, antipsychotics), psychotherapy (such as cognitive behavioral therapy), and in severe cases, electroconvulsive therapy (ECT).
In simple words: This diagnosis means the person is currently experiencing a severe form of bipolar disorder where they have both extreme highs and lows at the same time, along with symptoms like hallucinations or delusions that make it hard to distinguish what's real.
This code signifies a current episode of bipolar I disorder characterized by a mixed state that is severe and includes psychotic features such as delusions or hallucinations.The individual experiences both manic and depressive symptoms concurrently.The psychotic features may or may not be congruent with the mood episode.
Example 1: A patient presents with rapid, pressured speech, racing thoughts, decreased need for sleep, and inflated self-esteem (mania), while simultaneously expressing feelings of worthlessness, guilt, and suicidal ideation (depression). They also report hearing voices telling them they are a failure., A patient experiences a period of severe agitation, irritability, and destructive behavior while also expressing feelings of profound sadness and hopelessness.They have delusions of persecution, believing that others are trying to harm them., An individual experiencing a mixed episode exhibits both manic symptoms like increased energy and impulsivity, and depressive symptoms like sadness and loss of interest, coupled with hallucinations where they see things that are not there. The severity of these symptoms significantly impacts their daily functioning.
Documentation should include detailed descriptions of the patient's mood episodes, including the presence and nature of both manic and depressive symptoms.Evidence of psychotic features, such as delusions or hallucinations, should be clearly documented, including their content and impact on the patient's functioning.It's important to distinguish mood-congruent psychotic features (consistent with the mood) from mood-incongruent features (inconsistent with the mood).The severity of the episode and its impact on the individual's daily life should also be documented.Any relevant psychosocial factors, medical history, and family history should be noted, as well as response to treatment.
- Specialties:Psychiatry, Psychology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Psychiatric Facility-Partial Hospitalization, Residential Substance Abuse Treatment Facility, Office