F31.5
BillableBipolar disorder, current episode depressed, severe, with psychotic features
HCC Category Mapping
V28HCC 152 — Delusional and Other Specified Psychotic Disorders
0.546V24HCC 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 includes psychotic features such as hallucinations or false beliefs.
Coding Tips
- •Confirm documentation of both severe depression AND psychotic symptoms (hallucinations, delusions, or disorganized thinking)
- •This code indicates more severe illness requiring closer monitoring and potentially different treatment approaches
Clinical Significance
Bipolar disorder with current severe depressive episode with psychotic features represents one of the most clinically acute psychiatric presentations, combining profound depression with psychotic symptoms such as mood-congruent delusions of guilt, worthlessness, or nihilism. This condition typically requires inpatient hospitalization and carries extremely high suicide risk. The psychotic component significantly increases treatment complexity and cost.
Documentation Requirements
- ✓Confirmed bipolar disorder diagnosis
- ✓Current depressive episode documented as severe
- ✓Specific psychotic features described: delusions (guilt, somatic, nihilistic) and/or hallucinations
- ✓Comprehensive suicide risk assessment
- ✓Mental status examination documenting psychotic features
- ✓Antipsychotic medication in addition to mood stabilizers
- ✓Hospitalization or crisis intervention documentation
Commonly Confused Codes
F31.4 — Bipolar disorder, depressed, severe without psychotic features: No psychotic symptomsF31.2 — Bipolar disorder, manic, severe with psychotic features: Manic rather than depressive episodeF32.3 — Major depressive disorder, single episode, severe with psychotic features: No bipolar historyF25.1 — Schizoaffective disorder, depressive type: Psychotic features persist between mood episodes
Code Hierarchy
└F31Bipolar disorder└F31.5Bipolar disorder, current episode depressed, severe, with psychotic features
└F31.5Bipolar disorder, current episode depressed, severe, with psychotic features