F32.3 vs R44-
F32.3 and R44 are not coded together. ICD-10-CM declares them mutually exclusive with an Excludes1 note — the two conditions are not expected to occur together, so exactly one of them is normally correct for a given encounter. The Official Guidelines carve out one exception: if the two conditions are clearly unrelated to each other, both may be reported.
Major depressive disorder, single episode, severe with psychotic features
- Chapter 5
- Mental, Behavioral and Neurodevelopmental disorders
- Section
- F30-F39
- Single episode of major depression with mood-congruent psychotic symptoms
- Single episode of major depression with mood-incongruent psychotic symptoms
- Single episode of major depression with psychotic symptoms
- Single episode of psychogenic depressive psychosis
- Single episode of psychotic depression
- Single episode of reactive depressive psychosis
- Depression › psychotic (single episode)
- Melancholia › reactive (emotional stress or trauma)
- Depression › major › with psychotic symptoms
- Depression › reactive › psychotic (single episode)
- Psychosis, psychotic › psychogenic › depressive
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