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Diagnosis code for bipolar


2023 ICD-10-CM Codes F31*: Bipolar disorder

  1. ICD-10-CM Codes
    2. ›
  2. F01-F99
    3. ›
  3. F30-F39
    4. ›
  4. Bipolar disorder F31

Type 1 Excludes

Type 1 Excludes Help

A type 1 excludes note is a pure excludes. It means "not coded here". A type 1 excludes note indicates that the code excluded should never be used at the same time as F31. A type 1 excludes note is for used for when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.

  • bipolar disorder, single manic episode (

    ICD-10-CM Diagnosis Code F30

    • F30 Manic episode
      • F30.1 Manic episode without psychotic symptoms
        • F30.10 Manic episode without psychotic symptoms, uns. ..
        • F30.11 Manic episode without psychotic symptoms, mil...
        • F30.12 Manic episode without psychotic symptoms, mod...
        • F30.13 Manic episode, severe, without psychotic symp...
      • F30.2 Manic episode, severe with psychotic symptoms...
      • F30.3 Manic episode in partial remission
      • F30.4 Manic episode in full remission
      • F30.8 Other manic episodes
      • F30.9 Manic episode, unspecified
    F30.-)
  • major depressive disorder, single episode (

    ICD-10-CM Diagnosis Code F32

    • F32 Depressive episode
      • F32.0 Major depressive disorder, single episode, mi...
      • F32.1 Major depressive disorder, single episode, mo...
      • F32.2 Major depressive disorder, single episode, se...
      • F32.3 Major depressive disorder, single episode, se...
      • F32.4 Major depressive disorder, single episode, in...
      • F32.5 Major depressive disorder, single episode, in...
      • F32.8 Other depressive episodes
        • F32. 81 Premenstrual dysphoric disorder
        • F32.89 Other specified depressive episodes
      • F32.9 Major depressive disorder, single episode, un...
      • F32.A Depression, unspecified
    F32.-)
  • major depressive disorder, recurrent (

    ICD-10-CM Diagnosis Code F33

    • F33 Major depressive disorder, recurrent
      • F33.0 Major depressive disorder, recurrent, mild
      • F33.1 Major depressive disorder, recurrent, moderat...
      • F33.2 Major depressive disorder, recurrent severe w...
      • F33.3 Major depressive disorder, recurrent, severe ...
      • F33.4 Major depressive disorder, recurrent, in remi...
        • F33.40 Major depressive disorder, recurrent, in remi...
        • F33.41 Major depressive disorder, recurrent, in part...
        • F33.42 Major depressive disorder, recurrent, in full...
      • F33.8 Other recurrent depressive disorders
      • F33.9 Major depressive disorder, recurrent, unspeci...
    F33. -)

Type 2 Excludes

Type 2 Excludes Help

A type 2 excludes note represents "not included here". A type 2 excludes note indicates that the condition excluded is not part of the condition it is excluded from but a patient may have both conditions at the same time. When a type 2 excludes note appears under a code it is acceptable to use both the code (F31) and the excluded code together.

Includes

Includes Help

"Includes" further defines, or give examples of, the content of the code or category.

  • bipolar I disorder
  • bipolar type I disorder
  • manic-depressive illness
  • manic-depressive psychosis
  • manic-depressive reaction
  • seasonal bipolar disorder

Clinical Information

  • A major affective disorder marked by severe mood swings (manic or major depressive episodes) and a tendency to remission and recurrence.
  • A major affective disorder marked by severe mood swings (manic or major depressive episodes) and a tendency to remission and recurrence. (mesh)
  • Bipolar disorder is a serious mental illness. People who have it go through unusual mood changes. They go from very happy, "up," and active to very sad and hopeless, "down," and inactive, and then back again. They often have normal moods in between. The up feeling is called mania. The down feeling is depression. The causes of bipolar disorder aren't always clear. It runs in families. Abnormal brain structure and function may also play a role. Bipolar disorder often starts in a person's late teen or early adult years. But children and adults can have bipolar disorder too. The illness usually lasts a lifetime.if you think you may have it, tell your health care provider. A medical checkup can rule out other illnesses that might cause your mood changes.if not treated, bipolar disorder can lead to damaged relationships, poor job or school performance, and even suicide. However, there are effective treatments to control symptoms: medicine and talk therapy. A combination usually works best.

Codes

  • F31 Bipolar disorder
    • F31.0 Bipolar disorder, current episode hypomanic
    • F31.1 Bipolar disorder, current episode manic without psychotic features
      • F31.10 …… unspecified
      • F31.11 …… mild
      • F31.12 …… moderate
      • F31.13 …… severe
    • F31.2 Bipolar disorder, current episode manic severe with psychotic features
    • F31.3 Bipolar disorder, current episode depressed, mild or moderate severity
      • F31.30 …… unspecified
      • F31.31 Bipolar disorder, current episode depressed, mild
      • F31.32 Bipolar disorder, current episode depressed, moderate
    • F31.4 Bipolar disorder, current episode depressed, severe, without psychotic features
    • F31.5 Bipolar disorder, current episode depressed, severe, with psychotic features
    • F31.6 Bipolar disorder, current episode mixed
      • F31. 60 …… unspecified
      • F31.61 …… mild
      • F31.62 …… moderate
      • F31.63 …… severe, without psychotic features
      • F31.64 …… severe, with psychotic features
    • F31.7 Bipolar disorder, currently in remission
      • F31.70 …… most recent episode unspecified
      • F31.71 Bipolar disorder, in partial remission, most recent episode hypomanic
      • F31.72 Bipolar disorder, in full remission, most recent episode hypomanic
      • F31.73 Bipolar disorder, in partial remission, most recent episode manic
      • F31.74 Bipolar disorder, in full remission, most recent episode manic
      • F31.75 Bipolar disorder, in partial remission, most recent episode depressed
      • F31.76 Bipolar disorder, in full remission, most recent episode depressed
      • F31.77 Bipolar disorder, in partial remission, most recent episode mixed
      • F31.78 Bipolar disorder, in full remission, most recent episode mixed
    • F31.8 Other bipolar disorders
      • F31. 81 Bipolar II disorder
      • F31.89 Other bipolar disorder
    • F31.9 Bipolar disorder, unspecified

2023 ICD-10-CM Diagnosis Code F31.9: Bipolar disorder, unspecified

F31.72 Bipolar disorder, in full remission, most recent episode hypomanic

F31.73 Bipolar disorder, in partial remission, most recent episode manic

F31.74 Bipolar disorder, in full remission, most recent episode manic

F31. 75 Bipolar disorder, in partial remission, most recent episode depressed

F31.76 Bipolar disorder, in full remission, most recent episode depressed

F31.77 Bipolar disorder, in partial remission, most recent episode mixed

F31.78 Bipolar disorder, in full remission, most recent episode mixed

F31. 8 Other bipolar disorders

F31.81 Bipolar II disorder

F31.89 Other bipolar disorder

F31.9 Bipolar disorder, unspecified

F32 Depressive episode

F32. 0 Major depressive disorder, single episode, mild

F32.1 Major depressive disorder, single episode, moderate

F32.2 Major depressive disorder, single episode, severe without psychotic features

F32.3 Major depressive disorder, single episode, severe with psychotic features

F32.4 Major depressive disorder, single episode, in partial remission

F32. 5 Major depressive disorder, single episode, in full remission

F32.8 Other depressive episodes

F32.81 Premenstrual dysphoric disorder

F32.89 Other specified depressive episodes

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.

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Bipolar disorder in adolescents - definition, causes, stages of development

According to the World Health Organization, bipolar disorder is in sixth place among the diseases that can provoke a disability in a patient. High incidence rates among adolescents lead to the need to find ways to solve this problem. The symptoms of bipolar disorder in adolescents are often explained by the characteristics of adolescence and are not considered as indicators of mental illness. In this connection, the patient goes to the doctor when his condition worsens significantly, while the quality of life decreases.

Disease definition

Bipolar disorder in adolescents is a disease characterized by alternating episodes of depression, mania, and an adequate state. These episodes can last from several weeks to several months.

In the ICD-10, bipolar affective disorder is coded F31 and is characterized as a disorder with two or more episodes in which the patient's activity level and mood are significantly impaired.

Bipolar personality disorder in adolescents was first described at the end of the 19th century by the German psychiatrist Emil Kraepelin, who defined it as manic-depressive psychosis. He considered the clinical picture of the disease and revealed a direct relationship between the increase in the number of depressive episodes and the age of the patient. The older a person is, the more often he experiences depression.

Young people from 15 to 25 years old are more susceptible to the disease. In children, the disease is rare, but in some cases it is at a younger age that the mechanism of mental changes is triggered. By gender, the ratio of cases is approximately equal.

Bipolar disorder in children and adolescents usually begins with an episode of depression that lasts indefinitely. If the state enters the manic (hypomanic) phase, the adolescent experiences euphoria accompanied by feelings of happiness or irritability. The stronger the previous depressive phase, the more pronounced the mania.

Adolescent bipolar disorder is a disease that will periodically make itself felt in adulthood. But with the help of medical and psychotherapeutic methods, it is possible to achieve long periods of remission, contributing to a long, rich, fulfilling life for the patient.

Symptoms of bipolar disorder in adolescents

They are associated with the phases of the disease - depressive and manic. The disease can manifest itself in only one phase, or hypomanic manifestations can form. In some cases, the phases replace each other - then we are talking about a mixed type of disease.

Despite the fact that the symptoms of bipolar disorder in adolescents from 14 to 17 years old have similar features, each case is individual. The number of phases, the frequency of their change and the duration differ in each case. Remission periods also take a different period of time and can last several years. At the end of the attack, mental health is restored and maintained until the next episode.

The main signs of bipolar disorder in adolescents are:

  1. Depressive episode of bipolar disorder. The main symptom of a depressive episode is pronounced depression, which occurs with the presence of psychoses and nervous disorders. The depressive state is characterized by a persistent clinical picture over a long period of time.

    2. Symptoms of bipolar personality disorder in adolescents include the following conditions and phenomena:

  • Sudden mood swings in the same tone (anxious and depressive thoughts are observed in the morning; by the evening the condition improves, but the anxiety does not leave the patient).
  • Loss of appetite and change in taste preferences (against the background of depression and anxiety, the patient refuses to eat or forgets to eat). Sometimes the opposite picture arises: appetite increases, temporary periods of sleep and wakefulness are disturbed, and the patient spends more time in a state of sleep.
  • Physical sensation of feelings of melancholy and anxiety. Night sleep does not bring relief. The patient complains of being tired in the morning.
  • Inhibited reaction to what is happening (the slowness of the flow of basic mental processes does not allow you to adequately respond to current affairs).
  • Delusional thoughts and hallucinations may occur. There are feelings of guilt, fear of imminent danger.

A characteristic symptom of bipolar disorder in adolescent girls is an irregular menstrual cycle or no menstrual cycle at all. Girls experience a depressive episode more vividly, completely immersing themselves in frustration.

One of the serious symptoms of depression is the presence of suicidal thoughts, which lead to appropriate actions. When the risk of suicide increases, the patient is hospitalized in the hospital of the clinic.

  • Manic episode of bipolar disorder

    • Symptoms and signs of bipolar disorder in an adolescent manic episode vary in severity. It can be hypomania (mild mania) or mania with pronounced mental manifestations.

    A manic episode manifests itself in the following states:

    • The patient experiences an inexplicable feeling of joy, has fun and jokes for no reason. The elevated mood does not leave him for a long time. Excessive activity, megalomania, self-confidence and rightness push him to all sorts of "exploits".
    • The desire to have time to do everything leads to a rush and the inability to focus on something specific. A teenager starts several things at the same time, but does not bring them to the end and forgets about what he did.
    • Actions do not keep pace with the thoughts that arise at the speed of light in the head of the patient.

    In the case of mild mania (hypomania), there is no pronounced social maladjustment, high spirits and activity do not interfere with existence and communication in society.

    Mania is not always fun and joy. One of the variants of the manic syndrome is the manifestation of mania of anger. In this case, the patient experiences irritation, anger; picks on trifles to others; gets nervous if someone asks again or asks questions.

  • Mixed episode of bipolar disorder

    • Symptoms of a mixed episode of bipolar affective disorder in adolescents include signs of bipolar disorder in adolescents 14, 15, 16 years of two episodes - depressive and manic. However, these episodes can last several weeks or hours. With a mixed type of disorder, the symptoms are most pronounced and lead to social maladaptation.

    Relatives of potential mental health clinic patients are wondering how to tell if a teenager has bipolar disorder. Adolescence is the most difficult period in a person's life, because there are changes in the body, both physically and mentally. The first signs of bipolar disorder in adolescents are often attributed to the characteristics of adolescence, when emotional instability, mood swings, depression, youthful maximalism are not considered as borderline states of the psyche.

    Although already at 12 years old, adolescents can see signs of bipolar disorder. Features of adolescence leave their mark on the mood and attitude to life. But some moments in the behavior of a teenager should alert his inner circle.

    Mental health professionals say that teens with bipolar disorder lose the ability to recognize the true emotions of others. Being in a state of depression, they perceive relatively neutral facial expressions in a negative way. They may feel that the other person is angry or afraid. Although in reality the interlocutor is calm and does not express any emotions. In addition, there are problems with memory, switching attention from one object to another. Symptoms of bipolar disorder in adolescents 18 years of age are pronounced, regardless of the episode in which the patient is.

    Causes of disease

    Despite the keen interest in the phenomenon of bipolar disorder, experts do not have an exact explanation for the causes of bipolar disorder in adolescents. There is an opinion that the disease is inherited. Certain genes are believed to influence a person's predisposition to pathology, but they have not been identified at this time. The family history is taken into account. If this disorder is detected in one family member, this does not mean that the whole family is at risk.

    Considering the cause-and-effect relationships in the formation of bipolar disorder in adolescents, experts pay attention to the associated risk factors: biological, emotional, social. Adolescents with other mental disorders are at risk: anxiety disorder, attention deficit hyperactivity disorder, a tendency to various kinds of addictions, etc.

    Bipolar episodes can be initiated by any stressful situations, psychological trauma and addictions. However, in most cases, the disease is formed without any apparent causes and external triggers.

    The pathogenesis of bipolar disorder in adolescents is not fully understood. The occurrence of the disease is due to a hereditary factor. It is believed that patients with bipolar disorder have abnormalities in the structure and functioning of the brain.

    In the course of research, it was found that brain activity in depressive and manic phases differ. The occurrence of depressive states is associated with a violation of the functions of the system of inhibitory neurons of the brain, the "Sleep-wakefulness" cycle. The manic phase is associated with increased tone of the sympathetic nervous system, disruption of the pituitary gland and thyroid gland.

    Developmental stages and classification of bipolar disorder

    Episodes of bipolar disorder in adolescents have a characteristic clinical picture that develops over several stages.

    A depressive episode includes 4 stages:

    1. Initial stage.
    2. The stage of increasing depression.
    3. stage of severe depression.
    4. Return to normal.

    There are 5 stages in a manic (hypomanic) episode:

    1. Hypomania (growing depression).
    2. Mania (severe depression).
    3. phase peak.
    4. Relief of symptoms.
    5. Return to normal.

    The classification of bipolar disorder in the ICD-10 bipolar affective disorder is indicated by the code F31.

    Given the nature of the course of the disease, experts distinguish the following manifestation of the pathological process:

    • bipolar course - the disease is characterized by a change in two phases (depressive and manic), between which there are periods of remission;
    • continual course - there are no periods of remission between the phases of a depressive and manic disorder. One phase is immediately replaced by another.
    • monopolar course - the patient suffers from either manic or depressive manifestations. Most often, adolescents are overcome by depression, the symptoms of which are of a pronounced clinical nature.

    Complications of the disease

    Complications of adolescent bipolar disorder include an altered perception of reality, which leads to an intense increase in the frequency of suicidal thoughts and actions. Various kinds of addictions (drug, alcohol) that occur against the background of episodes of the disease exacerbate the symptoms. If there are concomitant diseases, the pathological process reaches critical indications.

    The consequences of bipolar disorder in adolescents can significantly limit their normal functioning. The states of mania and depression affect the patient's relationship with others. Antisocial behavior is formed, as a result of which there are problems with the law. The patient can be dangerous both for himself and for other people.

    Extreme polar moods of the patient not only limit his life activity, but also interfere with the life of family members and close relatives. emotional instability, whether it be mania or depression, significantly change the daily lifestyle of the patient and his environment. The disease becomes a problem for the whole family, it affects the social, legal, material spheres of life.

    Bipolar disorder does not go away on its own. If left untreated, the clinical picture worsens. Periods of emotional mood swings become longer and more severe.

    In whatever episode of the disease a person is, his emotional state causes inconvenience to himself and others. Often relatives go to the doctor when a lot of time has passed since the first episode. Emotional instability, mood swings are usually attributed to the characteristics of adolescence. Prolonged lack of treatment leads to a worsening of the condition and an increase in the duration of depression and mania.

    At the first signs of a pathological change in mood, which has a bipolar tonality, it is necessary to contact a specialist who treats mental disorders.

    Diagnosis of bipolar disorder in adolescents

    A feature of this disease is that there are no laboratory and instrumental diagnostic methods. How to determine bipolar disorder in adolescents if it is not possible to identify the pathology based on the results of tests and examinations?

    When diagnosing bipolar disorder, special attention is paid to the symptoms of the disease. An informative diagnostic method is the collection of an anamnesis of the disease, in which the patient and his relatives or immediate environment participate.

    Bipolar disorder must be differentiated from other pathological conditions: schizophrenia, anxiety and hyperkinetic disorders, addictions of various origins. In most cases, the diagnosis of the disease is difficult, since adolescents, due to age, are characterized by frequent mood swings and emotional instability.

    An accurate diagnosis can be made by a specialist in a specialized clinic dealing with the treatment of mental disorders. He knows how to diagnose bipolar disorder in a teenager, determine the type and stage of the disease.

    Treatment of bipolar disorder in adolescents

    The choice of treatments for bipolar disorder in adolescents depends on the severity of the clinical picture. It can be urgent (to relieve acute symptoms), ongoing (to consolidate the therapeutic effect) and supportive (to stabilize the patient's condition).

    In the treatment of bipolar disorder in adolescents, medical and psychotherapeutic methods are used.

    1. Medical treatment

      2. Bipolar disorder in adolescents is an incurable disease. But with the help of drugs, success can be achieved in eliminating acute symptoms and restoring the social status of the patient.

      Drug therapy in adolescents is similar to how bipolar disorder is treated in adults, but the young age of the patient must be taken into account. It is strictly forbidden to prescribe medicines on your own. Only a doctor who specializes in the treatment of mental disorders can pick them up. Depending on the progressive episode, the patient is prescribed different groups of drugs, such as antidepressants, tranquilizers, antipsychotics, mood stabilizers, anti-anxiety drugs.

    2. Psychotherapy

    In psychotherapy, special methods have been developed to cope with the symptoms of the disease, as well as to prevent relapses:

    • Cognitive-behavioral psychotherapy (based on the relationship between the patient and his parents to correct the patient's condition).
    • Multi-family group psychoeducation along with individual family psychoeducation (determination of methods of drug treatment and strategies for solving emerging problems).
    • Dialectical behavioral therapy (a series of classes to reduce anxiety, depression, the frequency of suicidal thoughts).

    Psychotherapy is an effective method only if all the recommendations of specialists are followed. It is important to manage the symptoms of any episode of bipolar disorder, whether depressive or manic.

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    Disease prevention

    There is no specific prevention for bipolar disorder in adolescents. To minimize the occurrence of depressive, manic or mixed episodes, it is necessary to follow the doctor's recommendations. Supportive care to prevent symptoms is important.

    To achieve long-term remissions, the participation of a specialist psychotherapist is necessary. The use of psychotherapeutic and psychosocial methods of treatment and rehabilitation, filling out self-control sheets to track the dynamics contribute to the improvement of the patient's condition.

    Clinical recommendations for bipolar disorder in adolescents include not only adherence to medication and psychotherapeutic prescriptions. It is necessary to pay attention to the living conditions of a teenager, social factors that affect his emotional state.

    References:

    1. Zhmurov V.
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