F33.2: Major depressive disorder, recurrent severe without psychotic features
Billable ICD-10-CM code, FY2027
What ICD-10-CM says
Notes at F33, Major depressive disorder, recurrent (they apply to every code under it)
Includes
- recurrent episodes of depressive reaction
- recurrent episodes of endogenous depression
- recurrent episodes of major depression
- recurrent episodes of psychogenic depression
- recurrent episodes of reactive depression
- recurrent episodes of seasonal affective disorder
- recurrent episodes of seasonal depressive disorder
- recurrent episodes of vital depression
Excludes1 (never coded with F33.2)
- bipolar disorder (F31.-)
- manic episode (F30.-)
What F33.2 covers
F33.2 is for recurrent major depressive disorder when the current episode is severe and there are no psychotic features. Severity and the absence of psychosis are the clinician's assessment.
Psychiatry and behavioral health use it most. A first severe episode without psychosis is F32.2. A severe recurrent episode with psychotic symptoms is F33.3, and moderate is F33.1.
Billing and coding notes
The F33 category has an excludes1 for bipolar disorder (F31.-) and manic episode (F30.-). Severe depression in a patient with bipolar disorder is coded in F31, not with F33.2.
The code needs both "recurrent" and "severe" in the documentation, and psychotic features must be absent. If psychosis is documented, use F33.3. If the severity is not stated, the code is F33.9.
Related codes under F33
- F33.0 Major depressive disorder, recurrent, mild
- F33.1 Major depressive disorder, recurrent, moderate
- F33.3 Major depressive disorder, recurrent, severe with psychotic symptoms
- F33.4 Major depressive disorder, recurrent, in remission
- F33.8 Other recurrent depressive disorders
- F33.9 Major depressive disorder, recurrent, unspecified
Questions about F33.2
What is the difference between F33.2 and F33.3?
Both are recurrent, severe major depression. F33.2 is without psychotic features, and F33.3 is with psychotic symptoms.
Can F33.2 be coded with F31 bipolar codes?
No. Bipolar disorder is an excludes1 at F33, so the two are never reported together.
ICD-10-CM in CloudMedico
In CloudMedico, a visit's diagnoses come from the current ICD-10-CM list. For US practices, the visit flags a code that isn't billable on its date, and a superbill made from an invoice carries the visit's diagnoses.
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