ICD-10 Coding for Bipolar I Disorder(F31.11, F31.13, F31.2)
Complete ICD-10-CM coding and documentation guide for Bipolar I Disorder. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Bipolar I Disorder
F31.1-F31.13Primary Range
Bipolar I disorder with current manic episode
This range covers the various severities of manic episodes in Bipolar I Disorder.
F31.2Primary Range
Bipolar I disorder with current manic episode with psychotic features
This code is used when psychotic features are present during a manic episode.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| F31.11 | Bipolar I disorder, current episode manic, mild | Use when the manic episode is mild without psychotic features. |
|
| F31.13 | Bipolar I disorder, current episode manic, severe | Use when the manic episode is severe without psychotic features. |
|
| F31.2 | Bipolar I disorder, current episode manic with psychotic features | Use when psychotic features are present during a manic episode. |
|
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
Essential facts and insights about Bipolar I Disorder
Primary ICD-10-CM Codes for bipolar 1
Decision Criteria
clinical Criteria
- Presence of mild manic symptoms for at least 7 days
Applicable To
- Mild manic episode
Excludes
- Bipolar II disorder
Clinical Validation Requirements
- Documentation of mild manic symptoms lasting at least 7 days
Code-Specific Risks
- Risk of undercoding if severity is not properly assessed.
Coding Notes
- Ensure documentation specifies the severity and absence of psychotic features.
F31.13 - Bipolar I disorder, current episode manic, severe
Use when the manic episode is severe without psychotic features.
Applicable To
- Severe manic episode
Excludes
- Bipolar II disorder
Clinical Validation Requirements
- Severe impairment in social or occupational functioning
Coding Notes
Ensure documentation specifies the severity and absence of psychotic features.
F31.2 - Bipolar I disorder, current episode manic with psychotic features
Use when psychotic features are present during a manic episode.
Applicable To
- Manic episode with psychotic features
Excludes
- Bipolar II disorder
Clinical Validation Requirements
- Presence of delusions or hallucinations during manic episode
Coding Notes
Ensure documentation specifies the presence 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 I Disorder to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code F31.11.
Impact
Clinical: Impacts treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential for claim denial.
Mitigation Strategy
Use structured templates, Regular training on documentation standards
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Query provider for specific episode type and severity.
Impact
Reimbursement: Potential for claim denial., Compliance: Violates Excludes1 note., Data Quality: Leads to inaccurate clinical representation.
Mitigation Strategy
Only code F31.xx as it includes depressive episodes.
Impact
Using unspecified codes when specific codes are available.
Mitigation Strategy
Implement regular audits and training.
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 I Disorder, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Bipolar I Disorder
Use these documentation templates to ensure complete and accurate documentation for Bipolar I Disorder. These templates include all required elements for proper coding and billing.
Manic Episode Documentation
Specialty: PsychiatryRequired Elements
- Episode type
- Severity
- Psychotic features
- Functional impairment
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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