F30.3
BillableManic episode in partial remission
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F30.3 an HCC code?
Yes. F30.3 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 F30.3
For F30.3 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 F30.3 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F30.3 is the ICD-10-CM diagnosis code for manic episode in partial remission. A manic episode that is improving or has mostly resolved, where the person still has some residual manic symptoms but is no longer in the acute phase. F30.3 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, F30.3 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, F30.3 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 the timeline of symptom improvement and current functional status. Because F30.3 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 F30.3 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the timeline of symptom improvement and current functional status
- •Clarify whether this is partial remission (some symptoms remain) versus full remission (F30.4)
Clinical Significance
Manic episode in partial remission indicates a patient whose acute manic symptoms are improving but have not fully resolved. Some residual manic features may persist, such as mildly elevated mood, slightly increased energy, or reduced sleep need, but the full manic syndrome is no longer present. This code is clinically important for tracking treatment response and recovery trajectory. Continued medication and monitoring are typically required during partial remission.
Documentation Requirements
- ✓Documentation of a prior manic episode meeting full diagnostic criteria
- ✓Assessment indicating improvement from the acute phase but persistence of some manic symptoms
- ✓Description of the specific residual symptoms present
- ✓Comparison to the acute manic presentation showing improvement
- ✓Current medication regimen and treatment response
- ✓Plan for continued monitoring and medication management