F33.3 vs R44
F33.3 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.
Major depressive disorder, recurrent, severe with psychotic symptoms
- Chapter 5
- Mental, Behavioral and Neurodevelopmental disorders
- Section
- F30-F39
- 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
- Depression › endogenous › with psychotic symptoms (acute) (mental)
- Depression › psychotic › recurrent (acute) (mental)
- Depression › vital › with psychotic symptoms (acute) (mental)
- Psychosis, psychotic › reactive › depressive › recurrent
- Disorder › depressive › major › recurrent › 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