ICD-10 Coding for Bipolar Disorder 1(F31.1, F31.2)
Complete ICD-10-CM coding and documentation guide for Bipolar Disorder 1. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Bipolar Disorder 1
F31.0-F31.9Primary Range
Bipolar disorder
This range includes all codes related to bipolar disorder, specifying episode type, severity, and presence of psychotic features.
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 when the patient is experiencing a manic episode without psychotic features. |
|
| F31.2 | Bipolar disorder, current episode manic with psychotic features | Use when the patient is 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 disorder 1
Essential facts and insights about Bipolar Disorder 1
Primary ICD-10-CM Codes for bipolar disorder 1
Decision Criteria
clinical Criteria
- Manic episode without psychotic symptoms
Applicable To
- Manic episode without psychotic symptoms
Excludes
- Bipolar disorder, current episode manic with psychotic features (F31.2)
Clinical Validation Requirements
- Manic episode lasting at least 7 days
- Symptoms such as inflated self-esteem, decreased need for sleep, and racing thoughts
Code-Specific Risks
- Misclassification if psychotic features are present but not documented
Coding Notes
- Ensure documentation specifies the absence of psychotic features.
F31.2 - Bipolar disorder, current episode manic with psychotic features
Use when the patient is experiencing a manic episode with psychotic features.
Applicable To
- Manic episode with delusions or hallucinations
Excludes
- Bipolar disorder, current episode manic without psychotic features (F31.1)
Clinical Validation Requirements
- Manic episode lasting at least 7 days
- Presence of psychotic symptoms such as delusions or hallucinations
Coding Notes
Document specific psychotic features to justify the use of this code.
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 Disorder 1 to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code F31.1.
Impact
Clinical: Leads to misdiagnosis and inappropriate treatment., Regulatory: Increases audit risk due to lack of specificity., Financial: Potentially reduces reimbursement rates.
Mitigation Strategy
Use structured templates to ensure all features are documented., Regular training on documentation standards.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Increases risk of audit due to lack of specificity., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Ensure documentation specifies episode type and severity to use specific codes.
Impact
Using codes like F31.9 increases audit risk due to lack of specificity.
Mitigation Strategy
Ensure detailed documentation of episode type and severity.
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 Disorder 1, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Bipolar Disorder 1
Use these documentation templates to ensure complete and accurate documentation for Bipolar Disorder 1. These templates include all required elements for proper coding and billing.
Bipolar 1 disorder with current manic episode
Specialty: PsychiatryRequired Elements
- Episode type and duration
- Presence of psychotic features
- Functional impairment
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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