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F31.72 ICD-10-CM Code: Bipolar disorder, in full remission, most recent episode hypomanic

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

F31.72

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

Bipolar disorder, in full remission, most recent episode hypomanic

Bipolar disorder where the patient is completely symptom-free, and their most recent mood episode was a period of abnormally elevated mood (hypomanic episode).

Buddy the Bee presenting code insight

Buddy Insight

Bipolar disorder in full remission with the most recent episode being hypomanic indicates complete symptom resolution from the last hypomanic episode.

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

HCC 59

RAF 0.309

ACA/HHS

0

0

RAF 0

ESRD/PACE

HCC 59

RAF 0.0

RXHCC

HCC 131

RAF 0.0

Code Trumping

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Code Book Path

Official
F31Bipolar disorder
F31.7Bipolar disorder, currently in remission
F31.72Bipolar disorder, in full remission, most recent episode hypomanic

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for F31.72 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for F31.72 in this effective period.

Related Child Codes

Official
F31.70Bipolar disorder, currently in remission, most recent episode unspecified
F31.71Bipolar disorder, in partial remission, most recent episode hypomanic
F31.73Bipolar disorder, in partial remission, most recent episode manic
F31.74Bipolar disorder, in full remission, most recent episode manic
F31.75Bipolar disorder, in partial remission, most recent episode depressed

Includes

Official

ICD-10-CM does not list Includes notes for F31.72 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for F31.72 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for F31.72 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for F31.72 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for F31.72 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Confirmed bipolar disorder diagnosis with episode history
Most recent episode documented as hypomanic
Full remission status with complete absence of mood symptoms documented
Maintenance medication regimen

MEAT Support

HCC Buddy guidance
Confirmed bipolar disorder diagnosis with episode history
Most recent episode documented as hypomanic
Full remission status with complete absence of mood symptoms documented
Maintenance medication regimen

Audit Caution

HCC Buddy guidance
Using full remission when residual symptoms are present — should be partial remission (F31.71)
Stopping bipolar coding entirely when the patient is in remission but still on medication
Confusing full remission with cure — bipolar disorder is a lifelong diagnosis
Not coding the bipolar disorder at maintenance visits

Common Mistakes

HCC Buddy guidance
F31.71 — Bipolar disorder, partial remission, most recent hypomanic: Residual symptoms still present
F31.74 — Bipolar disorder, full remission, most recent manic: Last episode was full mania
Z86.59 — Personal history of mental and behavioral disorders: Only if bipolar is truly resolved and no longer managed
F31.70 — Bipolar disorder, remission, unspecified: Less specific

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 F31.72 an HCC code?

Yes. F31.72 maps to Major Depressive, Bipolar, and Paranoid Disorders under the V24 model but is not retained in V28.

HCC Category Mapping

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 F31.72

For F31.72to 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 F31.72 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

F31.72 is the ICD-10-CM diagnosis code for bipolar disorder, in full remission, most recent episode hypomanic. Bipolar disorder where the patient is completely symptom-free, and their most recent mood episode was a period of abnormally elevated mood (hypomanic episode). F31.72 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 older CMS-HCC V24 model, F31.72 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.

Full remission means no current symptoms; document the timeline of symptom resolution in the medical record. Because F31.72 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 F31.72 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Full remission means no current symptoms; document the timeline of symptom resolution in the medical record
  • Specify the most recent episode type to differentiate from other bipolar remission codes

Clinical Significance

Bipolar disorder in full remission with the most recent episode being hypomanic indicates complete symptom resolution from the last hypomanic episode. While the patient is stable, continued coding reflects the chronic nature of bipolar disorder and the need for ongoing medication management and monitoring. Full remission does not mean the condition is resolved.

Documentation Requirements

  • Confirmed bipolar disorder diagnosis with episode history
  • Most recent episode documented as hypomanic
  • Full remission status with complete absence of mood symptoms documented
  • Maintenance medication regimen
  • Monitoring and relapse prevention plan

Commonly Confused Codes

  • F31.71 — Bipolar disorder, partial remission, most recent hypomanic: Residual symptoms still present
  • F31.74 — Bipolar disorder, full remission, most recent manic: Last episode was full mania
  • Z86.59 — Personal history of mental and behavioral disorders: Only if bipolar is truly resolved and no longer managed
  • F31.70 — Bipolar disorder, remission, unspecified: Less specific

Child Codes

Code Hierarchy

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