F31.60 maps to CMS-HCC V28 154. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. 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 lookupF31.60

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

F31.60

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

Bipolar disorder, current episode mixed, unspecified

Bipolar disorder where the person is currently in a mixed episode (experiencing both manic and depressive symptoms simultaneously) with unspecified severity.

Buddy Insight

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

Mapped

HCC 154

Bipolar Disorders without Psy...

Coefficient HCC 154: 0.351 (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

F31Bipolar disorder F31.6Bipolar disorder, current episode mixed F31.60Bipolar disorder, current episode mixed, unspecified

Inclusion Terms

Official

No inclusion terms are included in this display for F31.60. Check the code and parent instructions in the Code Book.

Excludes 2

Official

symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99)Inherited from F01-F99, F31
cyclothymia (F34.0)Inherited from F01-F99, F31

Related Codes

Official

F31.61Bipolar disorder, current episode mixed, mild F31.62Bipolar disorder, current episode mixed, moderate F31.63Bipolar disorder, current episode mixed, severe, without psychotic features F31.64Bipolar disorder, current episode mixed, severe, with psychotic features

Includes

Official

disorders of psychological developmentInherited from F01-F99, F31
bipolar I disorderInherited from F01-F99, F31
bipolar type I disorderInherited from F01-F99, F31
manic-depressive illnessInherited from F01-F99, F31
manic-depressive psychosisInherited from F01-F99, F31
manic-depressive reactionInherited from F01-F99, F31
seasonal bipolar disorderInherited from F01-F99, F31

Excludes 1

Official

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

Code First

Official

No Code First sequencing instructions are included in this display for F31.60. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for F31.60. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for F31.60. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Confirmed bipolar disorder diagnosis

Documentation of concurrent manic and depressive symptoms meeting criteria for a mixed episode

Specific symptoms from both poles described (e.g., agitation, racing thoughts with depressed mood and hopelessness)

Severity level should be queried if not documented

MEAT Support

HCC Buddy guidance

Confirmed bipolar disorder diagnosis

Documentation of concurrent manic and depressive symptoms meeting criteria for a mixed episode

Specific symptoms from both poles described (e.g., agitation, racing thoughts with depressed mood and hopelessness)

Severity level should be queried if not documented

Audit Caution

HCC Buddy guidance

Coding a mixed episode as either pure mania or pure depression — when both symptom clusters are present simultaneously, use the mixed codes

Confusing rapid cycling (alternating episodes) with a true mixed episode (simultaneous symptoms)

Using unspecified severity when the provider has documented mild, moderate, or severe

Missing subtle mixed features such as irritability with depression or hopelessness during mania

Common Mistakes

HCC Buddy guidance

F31.10 — Bipolar disorder, manic episode: Pure mania without concurrent depressive features

F31.30 — Bipolar disorder, depressed episode: Pure depression without concurrent manic features

F31.61 — Bipolar disorder, mixed, mild: Use when mild severity is documented

F31.9 — Bipolar disorder, unspecified: Less specific, does not identify current episode type

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 F31.60 an HCC code?

Yes. F31.60 (Bipolar disorder, current episode mixed, unspecified) 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: F31.60 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: F31.60
Description: Bipolar disorder, current episode mixed, unspecified
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 F31.60 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for F31.60

For F31.60, 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

F31.60 is the ICD-10-CM diagnosis code for bipolar disorder, current episode mixed, unspecified. Bipolar disorder where the person is currently in a mixed episode (experiencing both manic and depressive symptoms simultaneously) with unspecified severity. F31.60 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, F31.60 maps to Bipolar Disorders without Psychosis (HCC 154) with a source-labeled community, non-dual, aged reference coefficient of 0.351. 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.

Use this code only when severity cannot be determined from documentation; otherwise use F31.61-F31.64. For F31.60, 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 F31.60 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Use this code only when severity cannot be determined from documentation; otherwise use F31.61-F31.64
•Mixed episodes require documentation of concurrent manic and depressive symptoms

Clinical Significance

Bipolar disorder with current mixed episode of unspecified severity indicates simultaneous manic and depressive symptoms, one of the most diagnostically challenging and treatment-resistant bipolar presentations. Mixed episodes carry elevated suicide risk because patients have the despair of depression combined with the energy and impulsivity of mania. Accurate identification is critical for appropriate treatment selection.

Documentation Requirements

✓Confirmed bipolar disorder diagnosis
✓Documentation of concurrent manic and depressive symptoms meeting criteria for a mixed episode
✓Specific symptoms from both poles described (e.g., agitation, racing thoughts with depressed mood and hopelessness)
✓Severity level should be queried if not documented
✓Suicide risk assessment
✓Treatment plan addressing the mixed state

Commonly Confused Codes

•F31.10: Bipolar disorder, manic episode: Pure mania without concurrent depressive features
•F31.30: Bipolar disorder, depressed episode: Pure depression without concurrent manic features
•F31.61: Bipolar disorder, mixed, mild: Use when mild severity is documented
•F31.9: Bipolar disorder, unspecified: Less specific, does not identify current episode type