Quick reference
- When to use
- Use F31.3 when the client has an established or newly diagnosed bipolar disorder with the current episode matching this code's specifier. Always document history of manic episodes for Bipolar I. Never assign without confirming episode polarity.
- Duration
- Manic episodes: minimum 7 days (or any duration if hospitalized). Hypomanic episodes: minimum 4 consecutive days. Depressive episodes: minimum 2 weeks. Track mood longitudinally with mood charts.
- Session codes
- Pair with CPT 90834/90837 for therapy sessions. Medication management: 99213/99214. Add 96127 for mood screening tools (MDQ, PHQ-9). Crisis: 90839. Consider 90847 for family psychoeducation.
- Key indicators
- Mood episodes (manic, hypomanic, or depressive) • History of at least one manic episode (Bipolar I) • Elevated energy + decreased sleep need • Grandiosity • Pressured speech • Risk-taking behavior • Cycling pattern
What F31.3 represents
The depressive phase of Bipolar I disorder. Many patients spend more time in depressive episodes than manic ones. The depressive episodes in bipolar disorder can be clinically indistinguishable from unipolar depression.
Key diagnostic criteria
- History of at least one manic episode
- Current episode meets MDD criteria
- Mild to moderate severity
- Not severe and without psychotic features
Documentation essentials
Document depressive symptoms, severity, and history of manic episodes. Track with mood scales. Monitor for mixed features.
Differential diagnosis
Critical to distinguish from unipolar MDD. Always assess for manic/hypomanic history before diagnosing depression.
Treatment planning
Mood stabilizers are primary treatment. Antidepressant monotherapy is contraindicated (risk of switching). Psychotherapy for depression.
Insurance & billing
Document bipolar history clearly. Supports ongoing mood stabilizer treatment.
Updates & changes
Monitor for updates on mixed features specifier.
Documentation pitfalls
Never prescribe antidepressant monotherapy for bipolar depression. Always document manic history.
References
- American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.).