Depressive disorder presents in different severities and with a variety of linked conditions — check for important documentation details for proper coding.
Anxiety and mood disorders like depression and bipolar disorder are among the most common mental disorders in older adults, according to the CDC. Depression, in particular, can have a significant impact on older adults, leading to physical, mental and social impairments and adverse effects on the course and complications of chronic disease. Here is a simple rundown to help you code depression correctly:
To Code Major Depressive Disorder, Look to Severity
Search the alphabetic index under “disorder, depressive, recurrent” for a patient with major depression that’s described as recurrent, according to a “See” note in the alphabetic index. This leads to F33.9 (Major depressive disorder, recurrent, unspecified).
- If a current episode of the diagnosis is further described as “mild” use F33.0 (Major depressive disorder, recurrent, mild), or
- If described as “moderate” use F33.1 (Major depressive disorder, recurrent, moderate).
- If it’s documented as “severe without psychotic features” code F33.2 (Major depressive disorder, recurrent severe without psychotic features), or
- If it’s documented as “severe with psychotic features” use F33.3 (Major depressive disorder, recurrent, severe with psychotic symptoms).
To Code Chronic Depression
Code a diagnosis described as “chronic depression” with F32.9, according to Q4 2013 Coding Clinic guidance.
To Code Manic Depression
Assign F31.9 (Bipolar disorder, unspecified) for a diagnosis of manic depression. The term “manic depression” has its own listing in the alphabetic index, which leads to F31.9. The code also lists “Manic depression” as an inclusion term.
To Code Depression and Bipolar Disorder
Code only the bipolar disorder. Do not assign an additional code for depression for a patient described as having both depression and bipolar disorder, based on Excludes 1 notes on categories F30.- (Manic episode) and F31.- (Bipolar disorder) and F32.- and F33.-.
To Code Depression and Anxiety
Assign F41.8 if the physician’s documentation says “anxiety with depression” or “depression with anxiety.” The word “with” provides the connection that the two diagnoses are linked.
Important Information About Antidepressant Medications
If the patient is taking an antidepressant drug, do not code depression or any other mental disorder unless one has been diagnosed by the patient’s physician. Psychiatric drugs can be prescribed for non-psychiatric conditions, for example, antidepressants can be prescribed for migraines and fibromyalgia.