What is ICD-10 code F30.12?

F30.12 is the ICD-10-CM diagnosis code for Manic episode without psychotic symptoms, moderate. A moderate manic episode where a person experiences elevated mood, increased energy, and racing thoughts without hallucinations or delusions, with noticeable functional impairment. F30.12 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. F30.12 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. F30.12 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. F30.12 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for F30.12?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For F30.12, V28 maps to Bipolar Disorders without Psychosis at RAF 0.351 while V24 mapped to Major Depressive, Bipolar, and Paranoid Disorders at RAF 0.309. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting F30.12?

Document specific functional impairments (work, social, or personal care disruption) to justify moderate severity Distinguish from mild (F30.11) by noting the degree of occupational or social dysfunction Because F30.12 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

2026 ICD-10-CM F30.12: Manic episode without

ICD-10-CM Code View

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Code lookupF30.12Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Mood [affective] disorders (F30-F39)

F30.12

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Manic episode without psychotic symptoms, moderate

A moderate manic episode where a person experiences elevated mood, increased energy, and racing thoughts without hallucinations or delusions, with noticeable functional impairment.

Buddy Insight

Manic episode without psychotic symptoms, moderate indicates a manic episode with noticeable functional impairment in occupational, social, or personal domains but without psychotic features.

CMS-HCC V28

Mapped

HCC 154

Bipolar Disorders without Psy...

RAF 0.351

CMS-HCC V24

Mapped

HCC 59

Major Depressive, Bipolar, an...

RAF 0.309

ACA/HHS

Mapped

HCC 88

HHS-HCC 88

Varies by metal level

ESRD/PACE

Mapped

HCC 59

Major Depressive, Bipolar, an...

RAF 0.066

RXHCC

Mapped

HCC 131

Bipolar Disorders

RAF 0.240

Code Book Path

Official

F30Manic episode

F30.1Manic episode without psychotic symptoms

F30.12Manic episode without psychotic symptoms, moderate

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for F30.12 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for F30.12 in this effective period.

Related Child Codes

Official

F30.10Manic episode without psychotic symptoms, unspecified

F30.11Manic episode without psychotic symptoms, mild

F30.13Manic episode, severe, without psychotic symptoms

Includes

Official

ICD-10-CM does not list Includes notes for F30.12 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for F30.12 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for F30.12 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for F30.12 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for F30.12 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documentation of manic symptoms lasting at least seven consecutive days

Provider assessment explicitly stating severity is 'moderate'

Description of specific functional impairments (occupational disruption, social difficulties, impaired judgment)

Confirmation that psychotic features are absent

MEAT Support

HCC Buddy guidance

Documentation of manic symptoms lasting at least seven consecutive days

Provider assessment explicitly stating severity is 'moderate'

Description of specific functional impairments (occupational disruption, social difficulties, impaired judgment)

Confirmation that psychotic features are absent

Audit Caution

HCC Buddy guidance

Not documenting specific functional impairments that distinguish moderate from mild severity

Using unspecified severity when the provider has documented moderate mania

Coding severe mania (F30.13) when impairment is moderate, or mild (F30.11) when impairment is clearly moderate

Confusing a single manic episode (F30) with bipolar disorder (F31) when the patient's longitudinal pattern supports bipolar diagnosis

Common Mistakes

HCC Buddy guidance

F30.11 — Manic episode, MILD has less functional impairment

F30.13 — Manic episode, SEVERE has more extensive impairment but still no psychotic features

F30.2 — Manic episode WITH psychotic symptoms includes hallucinations or delusions

F31.12 — Bipolar disorder, current episode manic, moderate is used within an established bipolar pattern

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is F30.12 an HCC code?

Yes. F30.12 (Manic episode without psychotic symptoms, moderate) maps to Bipolar Disorders without Psychosis under the CMS-HCC V28 risk adjustment model (and Major Depressive, Bipolar, and Paranoid Disorders under V24), with a community non-dual aged RAF of 0.351. It is billable for payment year 2026.

Coder answer: F30.12 is billable and maps to V28 HCC 154, Bipolar Disorders without Psychosis. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: F30.12
Description: Manic episode without psychotic symptoms, moderate
HCC (V28): HCC 154 — Bipolar Disorders without Psychosis
RAF: 0.351
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 154, Bipolar Disorders without Psychosis

0.351

V24HCC 59, Major Depressive, Bipolar, and Paranoid Disorders

0.309

ESRDHCC 59, Major Depressive, Bipolar, and Paranoid Disorders

0.066

RxHCCHCC 131, Bipolar Disorders

0.240

Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

Work F30.12 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for F30.12

For F30.12 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
EEvaluate: test results, medication response, or physical findings reviewed by the provider
AAssess: explicit mention in the assessment or plan with acknowledgment of status
TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed F30.12 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

F30.12 is the ICD-10-CM diagnosis code for manic episode without psychotic symptoms, moderate. A moderate manic episode where a person experiences elevated mood, increased energy, and racing thoughts without hallucinations or delusions, with noticeable functional impairment. F30.12 sits in the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99), within the section covering mood [affective] disorders (f30-f39).

Under the CMS-HCC V28 risk adjustment model, F30.12 maps to Bipolar Disorders without Psychosis (HCC 154) with a community, non-dual, aged base RAF weight of 0.351. Under the older CMS-HCC V24 model, F30.12 maps to Major Depressive, Bipolar, and Paranoid Disorders (HCC 59) with a community, non-dual, aged base RAF weight of 0.309. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.

Document specific functional impairments (work, social, or personal care disruption) to justify moderate severity. Because F30.12 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for F30.12 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Document specific functional impairments (work, social, or personal care disruption) to justify moderate severity
•Distinguish from mild (F30.11) by noting the degree of occupational or social dysfunction

Clinical Significance

Manic episode without psychotic symptoms, moderate indicates a manic episode with noticeable functional impairment in occupational, social, or personal domains but without psychotic features. The patient exhibits clear manic symptoms that are disruptive to daily life. Moderate manic episodes often require medication adjustment and may necessitate closer monitoring or partial hospitalization. Accurate severity documentation supports appropriate treatment intensity and resource allocation.

Documentation Requirements

✓Documentation of manic symptoms lasting at least seven consecutive days
✓Provider assessment explicitly stating severity is 'moderate'
✓Description of specific functional impairments (occupational disruption, social difficulties, impaired judgment)
✓Confirmation that psychotic features are absent
✓Documentation of treatment intensity appropriate for moderate severity
✓Assessment of escalation risk and safety plan

Commonly Confused Codes

•F30.11: Manic episode, MILD has less functional impairment
•F30.13: Manic episode, SEVERE has more extensive impairment but still no psychotic features
•F30.2: Manic episode WITH psychotic symptoms includes hallucinations or delusions
•F31.12: Bipolar disorder, current episode manic, moderate is used within an established bipolar pattern
•F30.10: Manic episode, unspecified severity should not be used when moderate severity is documented