F31.64: Bipolar disorder, current episode mixed, severe, with psychotic features
F31.64 is a billable, specific ICD-10-CM code for bipolar disorder, current episode mixed, severe, with psychotic features. It is valid for submission on a claim.
Check F31.64 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Bipolar disorder, current episode mixed with mood-congruent psychotic symptoms
- Bipolar disorder, current episode mixed with mood-incongruent psychotic symptoms
Excludes1 inherited from the categories above F31.64
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above F31.64
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with F31.64
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
F31.64 risk-adjusts. Under the CMS-HCC V28 model it maps to these categories:
- HCC 152 Psychosis, Except Schizophrenia0.484 RAF
- HCC 152 Psychosis, Except Schizophrenia0.484 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
F31.64 is named in 25 Medicare coverage policies: 24 listing it as supporting medical necessity, and 1 listing it as NOT covered. Which one applies depends on your Medicare contractor.
- A52434Health and Behavior Assessment/Intervention – Medical Policy Articlenot covered
- A56614Billing and Coding: Psychiatric Inpatient Hospitalization
- A56645Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
- A56685Billing and Coding: Partial Hospitalization Programs
Alphabetic index entries that lead here
- Disorder›bipolar›current episode›mixed›severe›with psychotic features
Code history
Unchanged in every release from FY2024 to FY2027.