2027 ICD-10-CM Diagnosis Code F33.3Major depressive disorder, recurrent, severe with psychotic symptoms
ICD-10-CM Codes›F01–F99›F30-F39›F33
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Risk Adjusts — HCC 152
- Chronic Condition
F33.3 is a billable ICD-10-CM diagnosis code for major depressive disorder, recurrent, severe with psychotic symptoms. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 885. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 293 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Depressive disorders.
For Medicare Advantage risk adjustment, F33.3 maps to CMS-HCC Category 152 (Psychosis, Except Schizophrenia) under the V28 model, adding a risk factor of about 0.484 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
F33.3 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.
Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Major depression with psychotic features
- Recurrent major depressive disorder with atypical features
- Recurrent major depressive disorder with catatonic features
- Recurrent major depressive episodes
- Recurrent major depressive episodes, severe, with psychosis
- Severe major depression with psychotic features
- Severe major depression with psychotic features, mood-congruent
- Severe major depression with psychotic features, mood-incongruent
- Severe recurrent major depression
- Severe recurrent major depression with psychotic features
- Severe recurrent major depression with psychotic features, mood-congruent
- Severe recurrent major depression with psychotic features, mood-incongruent
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to F33.3: its own notes plus those printed at F33 and Chapter 5. A note printed at a category, block or chapter applies to every code under it.
Includes
Further defines, or gives examples of, the content of the category.
- 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
- disorders of psychological development
Applicable To
Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.
- Endogenous depression with psychotic symptoms
- Major depressive disorder, recurrent, with psychotic features
- Recurrent severe episodes of major depression with mood-congruent psychotic symptoms
- Recurrent severe episodes of major depression with mood-incongruent psychotic symptoms
- Recurrent severe episodes of major depression with psychotic symptoms
- Recurrent severe episodes of psychogenic depressive psychosis
- Recurrent severe episodes of psychotic depression
- Recurrent severe episodes of reactive depressive psychosis
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name F33.3, its category, or a range that includes it.
Excludes1 10
These codes carry an Excludes1 note naming F33.3: they are not reported together with it, unless the two conditions are unrelated.
- F20 Schizophreniamood [affective] disorders with psychotic symptoms (F30.2, F31.2, F31.5, F31.64, F32.3, F33.3)
- F22 Delusional disordersmood [affective] disorders with psychotic symptoms (F30.2, F31.2, F31.5, F31.64, F32.3, F33.3)
- F25 Schizoaffective disordersmood [affective] disorders with psychotic symptoms (F30.2, F31.2, F31.5, F31.64, F32.3, F33.3)
- F53 Mental and behavioral disorders associated with the puerperium, not elsewhere classifiedmood disorders with psychotic features (F30.2, F31.2, F31.5, F31.64, F32.3, F33.3)
- R44 Other symptoms and signs involving general sensations and perceptionshallucinations in mood disorders with psychotic symptoms (F30.2, F31.5, F32.3, F33.3)
- F30 Manic episodemajor depressive disorder, recurrent (F33.-) names F33.-, which includes this code
- F31 Bipolar disordermajor depressive disorder, recurrent (F33.-) names F33.-, which includes this code
- F32 Depressive episoderecurrent depressive disorder (F33.-) names F33.-, which includes this code
- R40.1 Stupordepressive stupor (F31.-, F32.-, F33.-) names F33.-, which includes this code
- R53.8 Other malaise and fatigueexhaustion and fatigue due to recurrent depressive episode (F33-) names F33-, which includes this code
Excludes2 8
These codes carry an Excludes2 note naming F33.3: its condition is not part of those codes, and both may be reported when the patient has both.
- F23 Brief psychotic disordermood [affective] disorders with psychotic symptoms (F30.2, F31.2, F31.5, F31.64, F32.3, F33.3)
- F42 Obsessive-compulsive disorderobsessive-compulsive symptoms occurring in depression (F32.-, F33.-) names F33.-, which includes this code
- F44.2 Dissociative stupordepressive stupor (F32, F33) names F33, which includes this code
- F63.2 Kleptomaniadepressive disorder with stealing (F31.-, F32.-, F33.-) names F33.-, which includes this code
- F06.3 Mood disorder due to known physiological condition
- F90 Attention-deficit hyperactivity disorders
- F91 Conduct disorders
- F93.0 Separation anxiety disorder of childhood
Index to Diseases and InjuriesGuidance
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Major Depressive Disorder
disorder in which five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. symptoms include: depressed mood most of the day, nearly every day; markedly diminished interest or pleasure in activities most of the day, nearly every day; significant weight loss when not dieting or weight gain; insomnia or hypersomnia nearly every day; psychomotor agitation or retardation nearly every day; fatigue or loss of energy nearly every day; feelings of worthlessness or excessive or inappropriate guilt; diminished ability to think or concentrate, or indecisiveness, nearly every day; or recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt. (dsm-5)
Patient EducationClinical
Depression
Depression is more than a feeling of being sad or irritable for a few days. It's a serious mood disorder. As one of the most common mental disorders in the United States, depression can affect how you think, feel, and your everyday life.
The full article covers:
- What is depression?
- What are the different types of depression?
- What causes depression?
- Who is at risk of depression?
- What are the symptoms of depression?
- How is depression diagnosed?
- What are the treatments for depression?
- Can depression be prevented?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert F33.3 to ICD-9-CMHistory
Code HistoryHistory
Questions About F33.3Overview
What is the ICD-10 code for major depressive disorder, recurrent, severe with psychotic symptoms?
The ICD-10-CM code for major depressive disorder, recurrent, severe with psychotic symptoms is F33.3 (sometimes written as F333). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is F33.3 (Major depressive disorder, recurrent) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report major depressive disorder, recurrent, severe with psychotic symptoms on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does F33.3 group to?
When major depressive disorder, recurrent, severe with psychotic symptoms is the principal diagnosis on an inpatient stay, it groups to MS-DRG 885 (psychoses), which carries a relative weight of 1.3904. Higher weights mean higher Medicare reimbursement.
Is F33.3 a CC or MCC?
CMS lists F33.3 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 293 closely related codes in its exclusion list.
Can F33.3 be reported with a code from F31?
Not as a rule. The Excludes1 note at F33, which applies to F33.3, lists "bipolar disorder (F31.-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
What HCC is F33.3?
F33.3 (major depressive disorder, recurrent, severe with psychotic symptoms) maps to CMS-HCC Category 152 (Psychosis, Except Schizophrenia), commonly written as HCC 152, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 59 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. In the Part D prescription drug model it maps to RxHCC 132.
Does F33.3 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, F33.3 adds a risk adjustment factor of about 0.484 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.208 to 0.579 depending on the payment segment). A more severe related category (HCC 151) supersedes it when both are reported. See the full factor table on the HCC 152 category page.
