What is ICD-10 code F31.12?

F31.12 is the ICD-10-CM diagnosis code for Bipolar disorder, current episode manic without psychotic features, moderate. Bipolar disorder with a current moderate manic episode without psychotic features, where the person experiences significant elevated mood and increased activity with notable functional impairment. F31.12 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. F31.12 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. F31.12 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. F31.12 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.

Which HCC does F31.12 map to under V28?

F31.12 maps to CMS-HCC V28 HCC 154 (Bipolar Disorders without Psychosis). The category numbers, labels, and conditions come from the CMS-HCC V28 model file for payment year 2026.

2026 ICD-10-CM F31.12: Bipolar disorder, current

F31.12 maps to CMS-HCC V28 154. A source-labeled RAF reference is available. Documentation must support MEAT. MEAT criteria · RAF Calculator · HCC Buddy coding tools

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupF31.12Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

F31.12

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

Bipolar disorder, current episode manic without psychotic features, moderate

Bipolar disorder with a current moderate manic episode without psychotic features, where the person experiences significant elevated mood and increased activity with notable functional impairment.

Buddy Insight

Bipolar disorder with current moderate manic episode without psychotic features represents a clinically significant active manic state with notable functional impairment.

CMS-HCC V28

Mapped

HCC 154

Bipolar Disorders without Psy...

Code-level coefficient reference

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

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

N/A

—

Not risk-adjusted for this model/period.

Not mapped

RXHCC

Mapped

HCC 131

Bipolar Disorders

Code-level coefficient reference

Code Book Path

Official

F31Bipolar disorder

F31.1Bipolar disorder, current episode manic without psychotic features

F31.12Bipolar disorder, current episode manic without psychotic features, moderate

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for F31.12 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for F31.12 in this effective period.

Related Child Codes

Official

F31.10Bipolar disorder, current episode manic without psychotic features, unspecified

F31.11Bipolar disorder, current episode manic without psychotic features, mild

F31.13Bipolar disorder, current episode manic without psychotic features, severe

Includes

Official

ICD-10-CM does not list Includes notes for F31.12 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for F31.12 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for F31.12 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for F31.12 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for F31.12 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documented bipolar disorder diagnosis

Current manic symptoms explicitly described as moderate severity

Absence of psychotic features documented

Evidence of functional impairment in social or occupational domains

MEAT Support

HCC Buddy guidance

Documented bipolar disorder diagnosis

Current manic symptoms explicitly described as moderate severity

Absence of psychotic features documented

Evidence of functional impairment in social or occupational domains

Audit Caution

HCC Buddy guidance

Failing to differentiate moderate from severe when provider documentation is ambiguous — query for clarification

Using the unspecified code F31.10 when the provider has documented moderate severity

Confusing moderate mania with a mixed episode when some depressive symptoms are mentioned incidentally

Not capturing the current episode status — ensure documentation reflects the present encounter, not historical episodes

Common Mistakes

HCC Buddy guidance

F31.11 — Bipolar disorder, current episode manic, mild: Less functional impairment than moderate

F31.13 — Bipolar disorder, current episode manic, severe: Requires more profound impairment without psychotic features

F31.62 — Bipolar disorder, current episode mixed, moderate: Use when concurrent depressive symptoms are present alongside mania

F31.2 — Bipolar disorder, current episode manic severe with psychotic features: Requires psychotic symptoms

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 F31.12 an HCC code?

Yes. F31.12 (Bipolar disorder, current episode manic without psychotic features, moderate) maps to HCC 154, Bipolar Disorders without Psychosis under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.351. 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: F31.12 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: F31.12
Description: Bipolar disorder, current episode manic without psychotic features, moderate
HCC (V28): HCC 154 — Bipolar Disorders without Psychosis
RAF reference coefficient: 0.351
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 154, Bipolar Disorders without Psychosis

0.351

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 F31.12 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT Criteria for F31.12

For F31.12 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 F31.12 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

F31.12 is the ICD-10-CM diagnosis code for bipolar disorder, current episode manic without psychotic features, moderate. Bipolar disorder with a current moderate manic episode without psychotic features, where the person experiences significant elevated mood and increased activity with notable functional impairment. F31.12 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, F31.12 maps to Bipolar Disorders without Psychosis (HCC 154) with a source-labeled community, non-dual, aged reference coefficient of 0.351. No V24 mapping is shown for F31.12; use the applicable model and payment year when reviewing the V28 mapping. 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. 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.

Moderate severity indicates clear functional impairment in work, school, or social relationships. Because F31.12 maps to an HCC category, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) before the diagnosis is used for risk adjustment. 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 F31.12 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Moderate severity indicates clear functional impairment in work, school, or social relationships
•Document the degree of impairment and specific manic symptoms to support this severity level

Clinical Significance

Bipolar disorder with current moderate manic episode without psychotic features represents a clinically significant active manic state with notable functional impairment. Moderate mania typically involves observable behavioral changes, impaired judgment, and often requires medication adjustment or increased monitoring. This level of severity indicates meaningful healthcare resource utilization.

Documentation Requirements

✓Documented bipolar disorder diagnosis
✓Current manic symptoms explicitly described as moderate severity
✓Absence of psychotic features documented
✓Evidence of functional impairment in social or occupational domains
✓Treatment plan addressing the current episode including medication management

Commonly Confused Codes

•F31.11: Bipolar disorder, current episode manic, mild: Less functional impairment than moderate
•F31.13: Bipolar disorder, current episode manic, severe: Requires more profound impairment without psychotic features
•F31.62: Bipolar disorder, current episode mixed, moderate: Use when concurrent depressive symptoms are present alongside mania
•F31.2: Bipolar disorder, current episode manic severe with psychotic features: Requires psychotic symptoms