F25 vs F31.5
F25 and F31.5 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
F25
Schizoaffective disorders
Not billable
- Chapter 5
- Mental, Behavioral and Neurodevelopmental disorders
- Section
- F20-F29
F31.5
Bipolar disorder, current episode depressed, severe, with psychotic features
Billable
- Chapter 5
- Mental, Behavioral and Neurodevelopmental disorders
- Section
- F30-F39
Use when the record says
- Bipolar disorder, current episode depressed with mood-incongruent psychotic symptoms
- Bipolar disorder, current episode depressed with mood-congruent psychotic symptoms
- Bipolar I disorder, current or most recent episode depressed, with psychotic features
Indexed under
- Disorder › bipolar › currentepisode › depressed › with psychotic features (of)
- Disorder › bipolar › currentepisode › severe depression › with psychotic features (of)
- Disorder › bipolar › currentepisode › depressed › without psychotic features › severe › with psychotic features (of)
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027