ICD-10 Coding for Bipolar 1 Disorder(F31.1, F31.2)
Complete ICD-10-CM coding and documentation guide for Bipolar 1 Disorder. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Bipolar 1 Disorder
F31Primary Range
Bipolar disorder
This range includes all codes related to bipolar disorder, including specific codes for manic episodes, depressive episodes, and mixed episodes.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| F31.1 | Bipolar disorder, current episode manic without psychotic features | Use for patients experiencing a manic episode without psychotic features. |
|
| F31.2 | Bipolar disorder, current episode manic with psychotic features | Use for patients experiencing a manic episode with psychotic features. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for bipolar 1 disorder
Essential facts and insights about Bipolar 1 Disorder
Primary ICD-10-CM Codes for bipolar 1 disorder
Decision Criteria
clinical Criteria
- Presence of manic symptoms without psychosis
Applicable To
- Mild manic episode
- Moderate manic episode
- Severe manic episode without psychotic features
Excludes
- Bipolar disorder, current episode manic with psychotic features (F31.2)
Clinical Validation Requirements
- At least one manic episode lasting at least 7 days
- Symptoms such as grandiosity, decreased need for sleep, and increased goal-directed activity
Code-Specific Risks
- Ensure documentation specifies the absence of psychotic features.
Coding Notes
- Ensure the episode type and severity are clearly documented.
F31.2 - Bipolar disorder, current episode manic with psychotic features
Use for patients experiencing a manic episode with psychotic features.
Applicable To
- Severe manic episode with psychotic features
Excludes
- Bipolar disorder, current episode manic without psychotic features (F31.1)
Clinical Validation Requirements
- Manic episode with psychotic features such as delusions or hallucinations
Coding Notes
Document the presence and type of psychotic features.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Bipolar 1 Disorder to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code F31.1.
Impact
Clinical: May lead to inappropriate treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential loss of reimbursement for higher severity codes.
Mitigation Strategy
Use checklists to ensure all symptoms are documented., Regular training on documentation standards.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases the accuracy of patient records.
Mitigation Strategy
Ensure documentation specifies the current episode type and severity.
Impact
Failure to document psychotic features can lead to audit discrepancies.
Mitigation Strategy
Implement regular audits of clinical documentation.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Bipolar 1 Disorder, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Bipolar 1 Disorder
Use these documentation templates to ensure complete and accurate documentation for Bipolar 1 Disorder. These templates include all required elements for proper coding and billing.
Manic episode documentation
Specialty: PsychiatryRequired Elements
- Episode type
- Duration
- Symptoms
- Presence of psychosis
- Severity
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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