In simple words: This code describes a severe type of bipolar disorder where the person is experiencing a period of intense sadness and hopelessness, along with symptoms like seeing or hearing things that aren't there (hallucinations) or holding onto beliefs that aren't true (delusions). This is a serious condition that requires professional medical help.

This code signifies bipolar disorder in a patient currently experiencing a severe depressive episode accompanied by psychotic features such as delusions or hallucinations.The depressive episode is characterized by extreme sadness, hopelessness, and difficulty concentrating, alongside potential disruptions in sleep and appetite, and suicidal ideation. Psychotic symptoms may include delusions (false beliefs) or hallucinations (sensory perceptions without external stimuli), which may or may not be consistent with the depressive mood (mood-congruent or mood-incongruent).

Example 1: A 30-year-old patient presents with severe depression, including suicidal ideation, and reports hearing voices telling her to harm herself (auditory hallucinations). She also believes she is being followed by government agents (delusional thinking).A psychiatrist diagnoses her with F31.5., A 45-year-old patient with a history of bipolar disorder is experiencing a severe depressive episode. She is withdrawn, has lost significant weight, and has difficulty sleeping. She also believes that she is a failure and worthless (delusions of worthlessness). This episode is diagnosed as F31.5., A 22-year-old patient experiences a severe depressive episode within the context of bipolar disorder.She reports feelings of intense hopelessness and worthlessness, alongside hallucinations of insects crawling on her skin (tactile hallucinations). The psychiatrist confirms the diagnosis of F31.5 because of the severity and presence of psychotic features.

Detailed psychiatric history including past episodes, symptom duration, severity, and any family history of mood disorders.Documentation of psychotic symptoms (hallucinations, delusions), their nature, and severity.Results of any relevant laboratory tests (although there are no specific diagnostic tests for bipolar disorder). Mental status examination findings.Treatment plan including medication, psychotherapy, and any other interventions.

** Differential diagnosis from other mental health conditions with depressive and/or psychotic features is essential for accurate coding.Close attention to documentation is necessary to differentiate mood-congruent versus mood-incongruent psychotic features.Consider the use of additional codes for co-occurring disorders or conditions.