What is ICD-10 code F31.63?

F31.63 is the ICD-10-CM diagnosis code for Bipolar disorder, current episode mixed, severe, without psychotic features. Bipolar disorder with a severe mixed episode combining manic and depressive symptoms without psychotic features. It belongs to the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99). F31.63 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. F31.63 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. F31.63 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. F31.63 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.

What is the V28 vs V24 difference for F31.63?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For F31.63, V28 maps to Bipolar Disorders at RAF 0.265 while V24 mapped to Major Depressive, Bipolar, and Paranoid Disorders at RAF 0.309. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting F31.63?

Confirm severe severity and mixed episode presentation without psychotic symptoms in documentation Use F31.64 instead if psychotic features are documented Because F31.63 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

F31.63: Bipolar disorder, current episode mixed

ICD-10-CM Code View

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

Code lookupF31.63Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

F31.63

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

Bipolar disorder, current episode mixed, severe, without psychotic features

Bipolar disorder with a severe mixed episode combining manic and depressive symptoms without psychotic features.

Buddy Insight

CMS-HCC V28

Mapped

HCC 154

Bipolar Disorders

RAF 0.265

CMS-HCC V24

Mapped

HCC 59

Major Depressive, Bipolar, an...

RAF 0.309

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Mapped

HCC 59

Major Depressive, Bipolar, an...

RAF 0.0

RXHCC

Mapped

HCC 131

Bipolar Disorders

RAF 0.0

Code Trumping

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Code Book Path

Official

F31Bipolar disorder

F31.6Bipolar disorder, current episode mixed

F31.63Bipolar disorder, current episode mixed, severe, without psychotic features

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for F31.63 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for F31.63 in this effective period.

Related Child Codes

Official

F31.60Bipolar disorder, current episode mixed, unspecified

F31.61Bipolar disorder, current episode mixed, mild

F31.62Bipolar disorder, current episode mixed, moderate

F31.64Bipolar disorder, current episode mixed, severe, with psychotic features

Includes

Official

ICD-10-CM does not list Includes notes for F31.63 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for F31.63 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for F31.63 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for F31.63 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for F31.63 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Confirmed bipolar disorder diagnosis

Concurrent severe manic and depressive symptoms documented

Explicit absence of psychotic features

Comprehensive suicide risk assessment and safety planning

MEAT Support

HCC Buddy guidance

Confirmed bipolar disorder diagnosis

Concurrent severe manic and depressive symptoms documented

Explicit absence of psychotic features

Comprehensive suicide risk assessment and safety planning

Audit Caution

HCC Buddy guidance

Missing psychotic features that would upgrade to F31.64

Coding as pure mania or pure depression when both symptom clusters are present

Not documenting the suicide risk assessment expected with this severity level

Confusing a severe mixed episode with an agitated depression

Common Mistakes

HCC Buddy guidance

F31.64 — Bipolar disorder, mixed, severe with psychotic features: Requires documented psychotic symptoms

F31.62 — Bipolar disorder, mixed, moderate: Less severe presentation

F31.13 — Bipolar disorder, manic, severe without psychotic features: Pure manic episode

F31.4 — Bipolar disorder, depressed, severe without psychotic features: Pure depressive episode

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is F31.63 an HCC code?

Yes. F31.63 maps to Bipolar Disorders under the CMS-HCC V28 risk adjustment model (and Major Depressive, Bipolar, and Paranoid Disorders under V24).

HCC Category Mapping

V28HCC 154, Bipolar Disorders

0.265

V24HCC 59, Major Depressive, Bipolar, and Paranoid Disorders

0.309

ESRDHCC 59, Major Depressive, Bipolar, and Paranoid Disorders

0.000

RxHCCHCC 131, Bipolar Disorders

0.000

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 F31.63

For F31.63to 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 F31.63 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

F31.63 is the ICD-10-CM diagnosis code for bipolar disorder, current episode mixed, severe, without psychotic features. Bipolar disorder with a severe mixed episode combining manic and depressive symptoms without psychotic features. F31.63 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, F31.63 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, F31.63 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.

Confirm severe severity and mixed episode presentation without psychotic symptoms in documentation. Because F31.63 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 F31.63 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Confirm severe severity and mixed episode presentation without psychotic symptoms in documentation
•Use F31.64 instead if psychotic features are documented

Clinical Significance

Bipolar disorder with current severe mixed episode without psychotic features is among the most dangerous bipolar presentations, combining the energy and impulsivity of mania with the despair and suicidality of depression. These patients are at the highest risk for suicide attempts due to the combination of depressive hopelessness and manic disinhibition. Intensive treatment is almost always required.

Documentation Requirements

✓Confirmed bipolar disorder diagnosis
✓Concurrent severe manic and depressive symptoms documented
✓Explicit absence of psychotic features
✓Comprehensive suicide risk assessment and safety planning
✓Evidence of marked functional impairment
✓Intensive treatment plan including medication management and possibly hospitalization

Commonly Confused Codes

•F31.64: Bipolar disorder, mixed, severe with psychotic features: Requires documented psychotic symptoms
•F31.62: Bipolar disorder, mixed, moderate: Less severe presentation
•F31.13: Bipolar disorder, manic, severe without psychotic features: Pure manic episode
•F31.4: Bipolar disorder, depressed, severe without psychotic features: Pure depressive episode