2025 ICD-10-CM code F32.3
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Mental, Behavioral, and Neurodevelopmental disorders - Mood (affective) disorders Chapter V: Mental and behavioural disorders Feed
Major depressive disorder, single episode, severe with psychotic features.
Medical necessity for treatment of major depressive disorder with psychotic features is established by the presence of severe symptoms causing significant impairment in social, occupational, or other important areas of functioning.The diagnosis must meet the criteria specified in the DSM-5 or other widely accepted diagnostic manual. Treatment is considered medically necessary when less intensive interventions have failed or are deemed inappropriate given the severity of the condition.Documentation supporting the diagnosis and the need for treatment must be provided.
Diagnosis and treatment of major depressive disorder with psychotic features are typically the responsibility of a psychiatrist or other qualified mental health professional. This involves a comprehensive assessment of the patient's symptoms, medical history, and psychosocial functioning. Treatment may include medication (antidepressants and/or antipsychotics), psychotherapy (cognitive behavioral therapy, interpersonal therapy), and possibly electroconvulsive therapy (ECT) in severe cases.Monitoring the patient's response to treatment and making adjustments as needed is a crucial part of clinical responsibility.
In simple words: This code describes a serious case of depression where someone has had one episode of severe depression lasting at least two weeks, along with hallucinations (seeing or hearing things that aren't there) or delusions (false beliefs).This episode significantly affects their daily life, but after it ends, they don't experience those symptoms again.
This code signifies a single episode of major depressive disorder characterized by severe symptoms and the presence of psychotic features (delusions and/or hallucinations).The depressive symptoms must be present for at least two weeks and significantly impair the individual's mental and physical functioning.Psychotic symptoms may be mood-congruent (consistent with depressive themes) or mood-incongruent (inconsistent with depressive themes).Once the episode resolves, the individual does not experience further symptoms.
Example 1: A 35-year-old female presents with a two-week history of severely depressed mood, loss of interest in activities, significant weight loss, insomnia, feelings of worthlessness, and auditory hallucinations (hearing voices criticizing her). She has no prior history of similar episodes. This would be coded as F32.3., A 60-year-old male is admitted to the hospital with a severe depressive episode. He experiences delusions of persecution (believing people are out to get him), alongside several other depressive symptoms, including fatigue, difficulty concentrating, and significant weight loss. This is his first occurrence of this type.This scenario would be coded as F32.3., A 22-year-old individual experiences a severe depressive episode including anhedonia (loss of pleasure), sleep disturbances, and delusional thoughts about having extraordinary abilities (grandeur).They report no prior depressive episodes.This would be coded as F32.3.
Detailed documentation should include the duration and severity of depressive symptoms, the presence and nature of psychotic symptoms (delusions and/or hallucinations, specifying their content if possible), the impact on daily functioning, and the absence of prior episodes of major depression. A complete history of present illness, past psychiatric history, substance use history, and family history should also be documented.The provider's assessment, diagnostic criteria used (e.g., DSM-5), treatment plan, and response to treatment should be clearly noted.
** This code is specific to a single episode of major depressive disorder with psychotic features.If the patient has experienced multiple depressive episodes, the appropriate code from the F33 category (recurrent depressive disorder) should be used.The presence of mood-congruent or mood-incongruent psychotic features should be specified in the clinical documentation.
- Payment Status: Active
- Specialties:Psychiatry
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office,Psychiatric Facility-Partial Hospitalization