F31.5 vs R44
F31.5 and R44 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.
Bipolar disorder, current episode depressed, severe, with psychotic features
- Chapter 5
- Mental, Behavioral and Neurodevelopmental disorders
- Section
- F30-F39
- 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
- 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)
Other symptoms and signs involving general sensations and perceptions
- Chapter 18
- Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
- Section
- R40-R46
These two codes sit in different chapters of the Tabular List, which is usually the clearest signal that they describe different underlying processes rather than different degrees of the same one.
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