Quick reference
- When to use
- Use F33.1 when the client meets criteria for Major Depressive Disorder, Recurrent, Moderate. Confirm episode type (single vs. recurrent) and severity level before coding. Always screen for bipolar history before assigning a unipolar depression code.
- Duration
- Symptoms must be present for at least 2 weeks. For recurrent codes (F33.x), document history of prior episodes with periods of remission. Reassess severity each session using PHQ-9.
- Session codes
- Pair with CPT 90791 (intake), 90834 (45-min), or 90837 (60-min). Use 96127 for PHQ-9 screening. Add 90863 for pharmacological management with therapy. Crisis sessions: 90839 + 90840.
- Key indicators
- Depressed mood or loss of interest/pleasure (at least one required) • Sleep changes • Appetite/weight changes • Fatigue • Worthlessness or guilt • Concentration difficulty • Psychomotor changes • Suicidal ideation
What F33.1 represents
Multiple episodes of major depression with the current episode being moderate in severity. This is a very commonly used code in outpatient mental health settings.
Key diagnostic criteria
- At least two episodes of MDD
- Current episode moderate severity
- Period of remission between episodes
- PHQ-9 typically 10-14
Documentation essentials
Document episode history, current severity, treatment response patterns, and functional impact.
Differential diagnosis
Rule out bipolar disorder (essential with recurrent episodes), persistent depressive disorder, and medical causes.
Treatment planning
Strong consideration for maintenance pharmacotherapy given recurrence. Combined treatment recommended.
Insurance & billing
Well-accepted code. Recurrence supports ongoing treatment authorization.
Updates & changes
No significant coding changes anticipated.
Documentation pitfalls
Always screen for bipolar history. Document number and timing of prior episodes.
References
- American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.).