What is the ICD-10?
ICD-10 is a medical coding system used to translate the diagnosis of diseases from words into the alphanumeric system that makes the data easy to store, retrieve and interpret. ICD is the International Classification of Diseases designed by the World Health Organization (WHO).
The ICD-10 system also covers mental and behavioral disorders, including Depression, anxiety, etc. Professionals use this system to diagnose patients.
For Depression, the ICD-10 provides a set of signs and symptoms that indicate depression and its various shapes.
In ICD-10, the following depressive disorders are covered:
- Manic episode
- Mild depressive episode
- Moderate depressive episode
- Severe depressive episode
- Recurrent depressive episode
- Bipolar affective disorder
- Mixed affective episode
- Recurrent brief depressive disorder
- Postpartum Depression
Classification for Diagnosis of Depression
The classification for diagnosis of Depression started with the evolution of the Diagnostic Manual of Mental Disorders. The Committee on Nomenclature and Statistics of the American Psychiatric Association published this manual. Psychiatric syndromes were termed “disorders.”
These mental disorders were divided into two major groups:
- Cognitive dysfunctions are related to the impairment of the brain.
- Mental dysfunctions are associated with difficulty in adaptation and are secondary to psychiatric disorders.
How the ICD 10 System for Depression evolved:
The Manual of International Statistical Classification of Diseases, Injuries, and Causes of Death was adopted by WHO in 1948. WHO added a section on mental disorders in the sixth edition of the International List of Causes of Death and renamed it the ICD-6 Injuries and Causes of Death.
WHO introduced more terms and new concepts in ICD-8 in 1965. After the international community of psychiatrists expressed dissatisfaction with the classification of mental disorders in ICD-8, the World Health Organization made further changes to the section on mental disorders, introduced a classification of mental disorders in ICD-9, and incorporated a glossary relating to mental disorders in the section.
The ICD-9 maintained the concept of neurosis and psychosis. The ICD-10 classification removed the difference between neurosis and psychosis, only retaining the term neurotic in the group of “neurotic, stress-related, and somatoform disorders.”
Diagnosis Coding for Mental and Behavioral Disorders:
The coding for mental and behavioral disorders is covered in the F00-F99 classification. The diagnosis codes that cover various types of Depression and use in medical coding and billing to fulfill the medical necessities are:
Coverage of ICD 10 Code for Depression
F30- Mania (single episode)
F30.1- Mania without psychotic symptoms
F30.2- Mania with psychotic symptoms
F30.8- Other manic episodes
F30.9- Manic episodes, unspecified
F31- Bipolar affective disorder
F31.0- Bipolar affective disorder, currently hypomanic
F31.1- Bipolar affective disorder, currently manic without psychosis
F31.2- Bipolar affective disorder, currently manic with psychosis
F31.3- Bipolar affective disorder, currently mild or moderate Depression
F31.4- Bipolar affective disorder, currently severe Depression without psychosis
F31.5- Bipolar affective disorder, currently severe Depression with psychosis
F31.6- Bipolar affective disorder, currently mixed manic and depressive symptoms
F31.7- Bipolar affective disorder, currently in remission
F31.8- Other Bipolar disorders ( Bipolar II disorder, recurrent episodes of Mania)
F31.9- Bipolar affective disorder, unspecified
F32- Major Depressive Disorder, single episode
F32.0 Major Depressive Disorder, mild, single episode
F32.1- Major Depressive Disorder, moderate, single episode
F32.2- Major Depressive Disorder, severe without psychotic symptoms, single episode
F32.3- Major Depressive Disorder, severe with psychotic symptoms, single episode
F32.4- Major Depressive Disorder, partial remission, single episode
F32.5- Major Depressive Disorder, complete remission, single episode
F32.8- Other depressive episodes (Atypical Depression, single episode of masked Depression)
F32.9- Unspecified depressive episode
F33- Recurrent depressive disorder
F33.0- Recurrent Depressive Disorder, presently mild
F33.1- Recurrent Depressive Disorder, presently moderate
F33.2- Recurrent Depressive Disorder, presently severe without psychotic traits
F33.3- Recurrent Depressive Disorder, presently severe with psychotic traits
F33.4- Major Depressive Disorder, recurrent, in remission
F33.40- Major Depressive Disorder, recurrent, in remission, unspecified
F33.41- Major Depressive Disorder, recurrent, in partial remission
F33.42- Major Depressive Disorder, recurrent, in full remission
F33.8- Other recurrent depressive disorders
F33.9- Unspecified recurrent depressive disorders
F34- Persistent mood disorders
F34.0- Cyclothymia (persistently unstable mood with periods of Depression and mild elation)
F34.1- Dysthymia (chronic Depression lasting several years)
F34.8- Other persistent mood disorders
F34.9- Unspecified persistent mood disorders
F38- Other mood disorders
F38.0- Other single mood disorders
F38.1- Other recurrent mood disorders
F38.8- Other specified mood disorders
F39 Unspecified mood disorder (affective psychosis)
F53.0 Postpartum depression
ICD-10 Depression codes listed above are used for the following conditions
It includes extreme mood swings with emotional highs and lows. Hypomania is the state of euphoria with high energy that is unusually irritable. Low energy is associated with Depression.
ICD-10 covers some conditions related to Depression that a patient experiences most of the day on an almost regular basis. For example:
Set 1 (the most typical symptoms):
- 1-Depressed mood
- 2-Loss of interest in nearly all activities
- 3-Lethargy and loss of motivation
Set 2 (Other symptoms):
- Loss of appetite
- Disturbed sleep
- Reduced self-esteem or self-confidence
- Reduced concentration and attention
- Hopelessness and pessimistic approach
- Feelings of guilt and worthlessness
- Psychomotor agitation or retardation
- Recurrent thoughts of death or suicide
Somatic symptoms include:
- Loss of interest in activities
- Loss of pleasure
- Lack of emotional reactivity
- Depression at peaks in the morning
- Loss of appetite
- Significant weight loss
- Psychomotor retardation or agitation
- Disturbed or reduced sleep
- Marked loss of libido
Diagnostic Assessment for Depression
For mild depressive episodes:
At least two of the most typical and two other symptoms persisting with somatic symptoms for two weeks or more indicate mild Depression.
For moderate depressive episodes:
Two of the most typical and at least three of the other symptoms persisting with somatic symptoms for two weeks or more indicate moderate Depression.
For severe depressive episodes:
All three typical symptoms and at least four other symptoms with severe intensity persisting for two or more weeks indicate severe Depression.
Recurrent depressive disorder:
Reoccurring and repeated episodes of Depression characterize this disorder. There is no history of independent mood elevation. However, a brief bout of hypomania accompanying a depressive episode can occur. The first episode can occur at any age, and the onset may be insidious or acute. The duration of the episode varies from a few days to several months.
Bipolar affective disorder:
Two or more episodes of disturbed mood and activities, with some occasions of increased energy and elevated mood and others of Depression and low energy, characterize this disorder. Repeated episodes of Mania and hypomania only classify bipolar disorder.
Dysthymia is a chronic disorder. The Depression of mood lasts several years, but it is not sufficiently severe, or the individual episodes are not prolonged enough to diagnose it as recurrent depressive disorder.
The symptoms may include:
1. Depression for most of the day for almost two years.
2. At least three of the following symptoms:
3. Loss of interest in all activities
4. Persistent Lethargy or low energy
5. Sleep disturbance
7. Low self-esteem
9. Tearful ness
10. Social isolation
12. Less talking
13. Pessimism about the future
Cyclothymia refers to the persistently unstable mood accompanied by several periods of Depression and euphoria, but the periods are not long enough to diagnose it as bipolar disorder. The relatives of patients with bipolar disorder often develop cyclothymia which may turn into bipolar disorder eventually.
Postpartum Depression is the Depression that a mother undergoes after delivering a baby. Symptoms of Depression resemble those of a depressive episode, and their onset occurs up to four weeks after the delivery. Some parents report a lack of attachment with the baby or the partner, but ICD-10 does not cover these symptoms.
Alan M. Greenberg, Reed D. Goldstein, Harold Alan Pincus; Classification of Depression: Research and Diagnostic Criteria: DSM-IV and ICD-10; Biology of Depression. From Novel Insights to Therapeutic Strategies; 2005
Lars Vedel Kessing; Severity of depressive episodes according to ICD-10: prediction of risk of relapse and suicide; British Journal of Psychiatry; 2004
Coding for Major Depressive Disorder; AAPC; 2013
Depression ICD-10; ICD 10 Codes Mental Health Therapy Billing; TheraPlatform
ICD-10 Version: 2019; World Health Organization
Arlin Cuncic; What are the ICD-10 Criteria for Depression; verywellmind; 2022
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