F31 - Bipolar disorder

Clinical Information

• Bipolar Disorder-. a major affective disorder marked by severe mood swings (manic or major depressive episodes) and a tendency to remission and recurrence.

Specific Coding for Bipolar disorder

Non-specific codes like F31 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10 codes with a higher level of specificity when coding for bipolar disorder:

Patient Education

Bipolar Disorder

What is bipolar disorder?

Bipolar disorder is a mood disorder that can cause intense mood swings:

• Sometimes you may feel extremely "up," elated, irritable, or energized. This is called a manic episode.
• Other times you may feel "down," sad, indifferent, or hopeless. This is called a depressive episode.
• You may have both manic and depressive symptoms together. This is called a mixed episode.

Along with the mood swings, bipolar disorder causes changes in behavior, energy levels, and activity levels.

Bipolar disorder used to be called other names, including manic depression and manic-depressive disorder.

What are the types of bipolar disorder?

There are three main types of bipolar disorder:

• Bipolar I disorder involves manic episodes that last at least 7 days or manic symptoms so severe that you need immediate hospital care. Depressive episodes are also common. Those often last at least two weeks. This type of bipolar disorder can also involve mixed episodes.
• Bipolar II disorder involves depressive episodes. But instead of full-blown manic episodes, there are episodes of hypomania. Hypomania is a less severe version of mania.
• Cyclothymic disorder, or cyclothymia, also involves hypomanic and depressive symptoms. But they are not as intense or as long-lasting as hypomanic or depressive episodes. The symptoms usually last for at least two years in adults and for one year in children and teenagers.

With any of these types, having four or more episodes of mania or depression in a year is called "rapid cycling."

What causes bipolar disorder?

The exact cause of bipolar disorder is unknown. Several factors likely play a role in the disorder. They include genetics, brain structure and function, and your environment.

Who is at risk for bipolar disorder?

You are at higher risk for bipolar disorder if you have a close relative who has it. Going through trauma or stressful life events may raise this risk even more.

What are the symptoms of bipolar disorder?

The symptoms of bipolar disorder can vary. But they involve mood swings known as mood episodes:

• The symptoms of a manic episode can include
  • Feeling very up, high, or elated
  • Feeling jumpy or wired, more active than usual
  • Having a very short temper or seeming extremely irritable
  • Having racing thoughts and talking very fast
  • Needing less sleep
  • Feeling like you are unusually important, talented, or powerful
  • Do risky things that show poor judgment, such as eating and drinking too much, spending or giving away a lot of money, or having reckless sex
• The symptoms of a depressive episode can include
  • Feeling very sad, hopeless, or worthless
  • Feeling lonely or isolating yourself from others
  • Talking very slowly, feeling like you have nothing to say, or forgetting a lot
  • Having little energy
  • Sleeping too much
  • Eating too much or too little
  • Lack of interest in your usual activities and being unable to do even simple things
  • Thinking about death or suicide
• The symptoms of a mixed episode include both manic and depressive symptoms together. For example, you may feel very sad, empty, or hopeless, while at the same time feeling extremely energized.

Some people with bipolar disorder may have milder symptoms. For example, you may have hypomania instead of mania. With hypomania, you may feel very good and find that you can get a lot done. You may not feel like anything is wrong. But your family and friends may notice your mood swings and changes in activity levels. They may realize that your behavior is unusual for you. After the hypomania, you might have severe depression.

Your mood episodes may last a week or two or sometimes longer. During an episode, symptoms usually occur every day for most of the day.

How is bipolar disorder diagnosed?

To diagnose bipolar disorder, your health care provider may use many tools:

• A physical exam
• A medical history, which will include asking about your symptoms, lifetime history, experiences, and family history
• Medical tests to rule out other conditions
• A mental health evaluation. Your provider may do the evaluation or may refer you to a mental health specialist to get one.

What are the treatments for bipolar disorder?

Treatment can help many people, including those with the most severe forms of bipolar disorder. The main treatments for bipolar disorder include medicines, psychotherapy, or both:

• Medicines can help control the symptoms of bipolar disorder. You may need to try several different medicines to find which one works best for you. Some people need to take more than one medicine. It's important to take your medicine consistently. Don't stop taking it without first talking with your provider. Contact your provider if you have any concerns about side effects from the medicines.
• Psychotherapy (talk therapy) can help you recognize and change troubling emotions, thoughts, and behaviors. It can give you and your family support, education, skills, and coping strategies. There are several different types of psychotherapy that may help with bipolar disorder.
• Other treatment options include
  • Electroconvulsive therapy (ECT), a brain stimulation procedure that can help relieve symptoms. ECT is most often used for severe bipolar disorder that is not getting better with other treatments. It may also be used when someone needs a treatment that will work more quickly than medicines. This might be when a person has a high risk of suicide or is catatonic (unresponsive).
  • Getting regular aerobic exercise may help with depression, anxiety, and trouble sleeping
  • Keeping a life chart can help you and your provider track and treat your bipolar disorder. A life chart is a record of your daily mood symptoms, treatments, sleep patterns, and life events.

Bipolar disorder is a lifelong illness. But long-term, ongoing treatment can help manage your symptoms and enable you to live a healthy, successful life.

NIH: National Institute of Mental Health

Bipolar disorder

Bipolar disorder is a mental health condition that causes extreme shifts in mood, energy, and behavior. This disorder most often appears in late adolescence or early adulthood, although symptoms can begin at any time of life.

People with bipolar disorder experience both dramatic "highs," called manic episodes, and "lows," called depressive episodes. These episodes can last from hours to weeks, and many people have no symptoms between episodes.

Manic episodes are characterized by increased energy and activity, irritability, restlessness, an inability to sleep, and reckless behavior. Some people with bipolar disorder experience hypomanic episodes, which are similar to but less extreme than manic episodes.

Depressive episodes are marked by low energy and activity, a feeling of hopelessness, and an inability to perform everyday tasks. People with bipolar disorder often have repeated thoughts of death and suicide, and they have a much greater risk of dying by suicide than the general population.

Manic and depressive episodes can include psychotic symptoms, such as false perceptions (hallucinations) or strongly held false beliefs (delusions). Mixed episodes, which have features of manic and depressive episodes at the same time, also occur in some affected individuals.

Bipolar disorder is classified into several types based on the mood changes that occur. Bipolar I involves manic episodes, which can be accompanied by psychotic symptoms, and hypomanic or depressive episodes. Bipolar II involves hypomanic episodes and depressive episodes. Cyclothymic disorder involves hypomanic episodes and depressive episodes that are typically less severe than those in bipolar I or bipolar II.

Bipolar disorder often occurs with other mental health conditions, including anxiety disorders (such as panic attacks), behavioral disorders (such as attention-deficit/hyperactivity disorder), and substance abuse.

Code History

• FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
• FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
• FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
• FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
• FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
• FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
• FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
• FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)