F30.13
BillableManic episode, severe, without psychotic symptoms
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F30.13 an HCC code?
Yes. F30.13 maps to Bipolar Disorders under the CMS-HCC V28 risk adjustment model (and Major Depressive, Bipolar, and Paranoid Disorders under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. 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.
MEAT Criteria for F30.13
For F30.13 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 F30.13 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F30.13 is the ICD-10-CM diagnosis code for manic episode, severe, without psychotic symptoms. A severe manic episode where a person experiences extreme elevated mood, increased energy, and racing thoughts, but does not have psychotic symptoms like hallucinations or delusions. This is a serious mental health condition requiring immediate clinical attention. F30.13 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, F30.13 maps to Bipolar Disorders (HCC 154) with a community, non-dual, aged base RAF weight of 0.265. Under the older CMS-HCC V24 model, F30.13 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.
Ensure documentation clearly distinguishes between 'severe' manic episodes and other severity levels (mild/moderate) to support accurate code selection. Because F30.13 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 F30.13 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Ensure documentation clearly distinguishes between 'severe' manic episodes and other severity levels (mild/moderate) to support accurate code selection
- •Verify that psychotic features are absent; if hallucinations or delusions are present, use F30.2x codes instead
Clinical Significance
Manic episode, severe without psychotic symptoms represents the most intense non-psychotic manic episode with extensive functional impairment. The patient may show extreme grandiosity, reckless behavior, minimal sleep, marked agitation, and severely impaired judgment. These patients often require inpatient psychiatric hospitalization for safety. Despite the absence of psychotic features, this is a psychiatric emergency requiring immediate intervention.
Documentation Requirements
- ✓Documentation of manic symptoms lasting at least seven consecutive days
- ✓Provider assessment explicitly stating severity is 'severe'
- ✓Description of extensive functional impairment (inability to work, severely impaired relationships, dangerous behaviors)
- ✓Specific confirmation that psychotic features (hallucinations, delusions) are ABSENT
- ✓Level of care documentation (inpatient, intensive outpatient) appropriate for severe mania
- ✓Safety assessment including risk behaviors, need for containment, and treatment plan
Commonly Confused Codes
- •F30.2 — Manic episode, severe WITH psychotic symptoms; verify NO psychotic features are present before using F30.13
- •F30.12 — Manic episode, MODERATE has less severe functional impairment
- •F31.13 — Bipolar disorder, current episode manic, severe is used within an established bipolar pattern
- •F31.2 — Bipolar disorder with psychotic features; different diagnosis entirely
- •F30.10 — Unspecified severity should not be used when severe mania is documented