F31.73
BillableBipolar disorder, in partial remission, most recent episode manic
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F31.73 an HCC code?
Yes. F31.73 maps to Bipolar Disorders under the CMS-HCC V28 risk adjustment model (and Major Depressive, Bipolar, and Paranoid Disorders under V24).
HCC Category Mapping
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 F31.73
For F31.73 to 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 F31.73 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F31.73 is the ICD-10-CM diagnosis code for bipolar disorder, in partial remission, most recent episode manic. This code describes bipolar disorder where the patient has experienced a manic episode that is now improving but not completely resolved. The person still has some symptoms of mania remaining, but they are less severe than during the active episode. F31.73 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, F31.73 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, F31.73 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.
Verify documentation clearly states 'partial remission' and confirms the most recent episode was manic (not depressive or mixed) to ensure accurate code selection. Because F31.73 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 F31.73 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify documentation clearly states 'partial remission' and confirms the most recent episode was manic (not depressive or mixed) to ensure accurate code selection
- •Do not use this code if the patient is in full remission; use F31.70 instead, or if symptoms are currently active, select the appropriate active episode code
Clinical Significance
Bipolar disorder in partial remission with the most recent episode being manic indicates recovery from a full manic episode with residual symptoms still present. Partial remission from mania suggests ongoing mood instability and higher risk for relapse into another manic or depressive episode. Close monitoring and medication adherence are critical during this transition period.
Documentation Requirements
- ✓Confirmed bipolar disorder diagnosis
- ✓Most recent episode documented as manic (not hypomanic)
- ✓Partial remission status with residual symptoms described
- ✓Current medication management plan
- ✓Assessment of functional recovery
- ✓Relapse prevention strategies documented