Excludes1 pair

F33.3 vs F53-

F33.3 and F53 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.

The official note, declared on F53
mood disorders with psychotic features (F30.2, F31.2, F31.5, F31.64, F32.3, F33.3)
F33.3

Major depressive disorder, recurrent, severe with psychotic symptoms

Billable
Chapter 5
Mental, Behavioral and Neurodevelopmental disorders
Section
F30-F39
Use when the record says
  • Endogenous depression with psychotic symptoms
  • Major depressive disorder, recurrent, with psychotic features
  • Recurrent severe episodes of major depression with mood-congruent psychotic symptoms
  • Recurrent severe episodes of major depression with mood-incongruent psychotic symptoms
  • Recurrent severe episodes of major depression with psychotic symptoms
  • Recurrent severe episodes of psychogenic depressive psychosis
  • Recurrent severe episodes of psychotic depression
  • Recurrent severe episodes of reactive depressive psychosis
Indexed under
  • Depression › endogenous › with psychotic symptoms
  • Depression › psychotic › recurrent
  • Depression › vital › with psychotic symptoms
  • Psychosis, psychotic › reactive › depressive › recurrent
  • Disorder › depressive › major › recurrent › with psychotic features
F53

Mental and behavioral disorders associated with the puerperium, not elsewhere classified

Not billable
Chapter 5
Mental, Behavioral and Neurodevelopmental disorders
Section
F50-F59

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