F30.2 maps to CMS-HCC V28 152. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC coding software

ICD-10-CM Code View

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Code lookupF30.2

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

F30.2

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

Manic episode, severe with psychotic symptoms

A severe manic episode where a person experiences extreme elevated mood, increased energy, and racing thoughts, along with psychotic symptoms such as hallucinations or delusions. This is a serious mental health condition requiring immediate medical attention.

Buddy Insight

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

Mapped

HCC 152

Psychosis, Except Schizophrenia

Coefficient HCC 152: 0.484 (Community Non-Dual Aged (CNA))

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

Context needed

HCC 088

Conditional HHS-HCC mapping: HCC 088 when age >= 2. Select the member context before showing a coefficient reference. Metal level and model segment are required for coefficients; no single RAF is shown.

Coefficient needs member context

ESRD/PACE

Context needed

HCC 59

ESRD candidates: HCC 59 when age >= 2 or age < 2. ESRD mapping is separate from PACE. Dialysis, graft, age, and other member context determine the applicable coefficient.

Coefficient needs member context

RXHCC

Mapped

HCC 131

Bipolar Disorders

Code-level coefficient reference

Code Book Path

Official

F30Manic episode F30.2Manic episode, severe with psychotic symptoms

Inclusion Terms

Official

Manic stupor
Mania with mood-congruent psychotic symptoms
Mania with mood-incongruent psychotic symptoms

Excludes 2

Official

symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99)Inherited from F01-F99

Related Codes

Official

F30.1Manic episode without psychotic symptoms F30.3Manic episode in partial remission F30.4Manic episode in full remission F30.8Other manic episodes F30.9Manic episode, unspecified

Includes

Official

disorders of psychological developmentInherited from F01-F99, F30
bipolar disorder, single manic episodeInherited from F01-F99, F30
mixed affective episodeInherited from F01-F99, F30

Excludes 1

Official

bipolar disorder (F31.-)Inherited from F30
major depressive disorder, single episode (F32.-)Inherited from F30
major depressive disorder, recurrent (F33.-)Inherited from F30

Code First

Official

No Code First sequencing instructions are included in this display for F30.2. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for F30.2. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for F30.2. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Documentation of severe manic symptoms lasting at least seven consecutive days

Description of specific psychotic features (type of delusions, type of hallucinations)

Assessment by a qualified psychiatrist

Documentation of inpatient level of care or justification for outpatient management

MEAT Support

HCC Buddy guidance

Documentation of severe manic symptoms lasting at least seven consecutive days

Description of specific psychotic features (type of delusions, type of hallucinations)

Assessment by a qualified psychiatrist

Documentation of inpatient level of care or justification for outpatient management

Audit Caution

HCC Buddy guidance

Coding severe mania without psychotic features (F30.13) when psychotic symptoms are documented

Confusing manic psychosis with schizoaffective disorder — key distinction is whether psychosis persists outside mood episodes

Not documenting the specific psychotic features (delusions type, hallucination type) that support this code

Using this code for bipolar disorder patients rather than the F31.2 bipolar-specific code when a bipolar pattern is established

Common Mistakes

HCC Buddy guidance

F30.13 — Manic episode, severe WITHOUT psychotic symptoms; verify psychotic features ARE present for F30.2

F25.0 — Schizoaffective disorder, bipolar type involves psychosis that persists OUTSIDE mood episodes

F31.2 — Bipolar disorder, current episode manic with psychotic features is used within an established bipolar pattern

F20.0 — Paranoid schizophrenia has persistent psychosis independent of mood episodes

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 F30.2 an HCC code?

Yes. F30.2 (Manic episode, severe with psychotic symptoms) maps to HCC 152, Psychosis, Except Schizophrenia under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.484. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: F30.2 is billable and maps to V28 HCC 152, Psychosis, Except Schizophrenia. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: F30.2
Description: Manic episode, severe with psychotic symptoms
HCC (V28): HCC 152 — Psychosis, Except Schizophrenia
RAF reference coefficient: 0.484
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 152, Psychosis, Except Schizophrenia

0.484

RxHCCHCC 131, Bipolar Disorders

Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. 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 context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work F30.2 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for F30.2

For F30.2, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

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

Coder workflow notes

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What This Code Means

F30.2 is the ICD-10-CM diagnosis code for manic episode, severe with psychotic symptoms. A severe manic episode where a person experiences extreme elevated mood, increased energy, and racing thoughts, along with psychotic symptoms such as hallucinations or delusions. This is a serious mental health condition requiring immediate medical attention. F30.2 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, F30.2 maps to Psychosis, Except Schizophrenia (HCC 152) with a source-labeled community, non-dual, aged reference coefficient of 0.484. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

Ensure documentation clearly specifies both the severity level (severe) and the presence of psychotic features before assigning this code. For F30.2, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. 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, source-labeled coefficient references, and MEAT documentation criteria for F30.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Ensure documentation clearly specifies both the severity level (severe) and the presence of psychotic features before assigning this code
•Do not use F30.2 if psychotic symptoms are absent; use F30.10 or F30.11 instead for manic episodes without psychosis

Clinical Significance

Manic episode, severe with psychotic symptoms represents the most severe form of mania, combining extreme manic symptoms with psychotic features such as grandiose delusions, paranoid delusions, or hallucinations. This is a psychiatric emergency requiring immediate inpatient hospitalization, antipsychotic medication, and close monitoring. The combination of severe mania and psychosis creates significant risk for self-harm, harm to others, and catastrophic decision-making.

Documentation Requirements

✓Documentation of severe manic symptoms lasting at least seven consecutive days
✓Description of specific psychotic features (type of delusions, type of hallucinations)
✓Assessment by a qualified psychiatrist
✓Documentation of inpatient level of care or justification for outpatient management
✓Safety assessment including danger to self and others
✓Medication regimen including both mood stabilizers and antipsychotics

Commonly Confused Codes

•F30.13: Manic episode, severe WITHOUT psychotic symptoms; verify psychotic features ARE present for F30.2
•F25.0: Schizoaffective disorder, bipolar type involves psychosis that persists OUTSIDE mood episodes
•F31.2: Bipolar disorder, current episode manic with psychotic features is used within an established bipolar pattern
•F20.0: Paranoid schizophrenia has persistent psychosis independent of mood episodes
•F19.950: Substance-induced psychotic disorder should be ruled out