F31.4
BillableBipolar disorder, current episode depressed, severe, without psychotic features
HCC Category Mapping
V28HCC 154 — Bipolar Disorders
0.265V24HCC 59 — Major Depressive, Bipolar, and Paranoid Disorders
0.309ESRDHCC 59 — Major Depressive, Bipolar, and Paranoid Disorders
0.000RxHCCHCC 131 — Bipolar Disorders
0.000What This Code Means
Bipolar disorder with a severe depressive episode that does not include psychotic symptoms like hallucinations or delusions.
Coding Tips
- •Document the severity level as 'severe' and confirm absence of psychotic features in the clinical record
- •Distinguish from F31.5 which includes psychotic features; review mental status examination documentation
Clinical Significance
Bipolar disorder with current severe depressive episode without psychotic features represents a high-acuity psychiatric state with profound functional impairment, significant suicidality risk, and potential need for hospitalization or intensive outpatient programs. Severe bipolar depression is one of the most treatment-resistant mood states and often requires complex polypharmacy. Accurate coding is essential for reflecting the true burden of this condition.
Documentation Requirements
- ✓Confirmed bipolar disorder diagnosis with episode history
- ✓Current depressive symptoms documented as severe
- ✓Explicit absence of psychotic features (no delusions or hallucinations)
- ✓Suicide risk assessment with documented safety plan
- ✓Evidence of marked functional impairment or inability to perform daily activities
- ✓Current treatment plan including medication regimen and therapy
Commonly Confused Codes
F31.5 — Bipolar disorder, depressed, severe with psychotic features: Requires documented psychotic symptomsF31.32 — Bipolar disorder, depressed, moderate: Less severe functional impairmentF32.2 — Major depressive disorder, single episode, severe: No bipolar historyF31.63 — Bipolar disorder, mixed, severe without psychotic features: Concurrent manic and depressive symptoms
Code Hierarchy
└F31Bipolar disorder└F31.4Bipolar disorder, current episode depressed, severe, without psychotic features
└F31.4Bipolar disorder, current episode depressed, severe, without psychotic features