2026 ICD-10-CM Diagnosis Code F31.64

Bipolar disorder, current episode mixed, severe, with psychotic features

ICD-10-CM Code:
F31.64
ICD-10 Code for:
Bipolar disord, crnt episode mixed, severe, w psych features
Is Billable?
Yes - Valid for Submission
Chronic Condition Indicator: [1]
Chronic
Code Navigator:

F31.64 is a billable diagnosis code used to specify a medical diagnosis of bipolar disorder, current episode mixed, severe, with psychotic features. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2025 through September 30, 2026.

Code Classification

  • Mental and behavioural disorders
    F01–F99
    • Mood [affective] disorders
      F30-F39
      • Bipolar disorder
        F31

Approximate Synonyms

The following list of clinical terms are approximate synonyms, alternative descriptions, or common phrases that might be used by patients, healthcare providers, or medical coders to describe the same condition. These synonyms and related diagnosis terms are often used when searching for an ICD-10 code, especially when the exact medical terminology is unclear. Whether you're looking for lay terms, similar diagnosis names, or common language alternatives, this list can help guide you to the correct ICD-10 classification.

  • Bipolar affective disorder, current episode mixed
  • Bipolar affective disorder, most recent episode mixed
  • Bipolar affective disorder, most recent episode mixed
  • Bipolar I disorder, most recent episode mixed with catatonic features
  • Mixed bipolar affective disorder, severe, with psychosis
  • Mixed bipolar I disorder
  • Mixed bipolar I disorder
  • Mixed bipolar I disorder
  • Severe bipolar disorder with psychotic features, mood-congruent
  • Severe bipolar disorder with psychotic features, mood-incongruent
  • Severe mixed bipolar I disorder
  • Severe mixed bipolar I disorder
  • Severe mixed bipolar I disorder
  • Severe mixed bipolar I disorder with psychotic features
  • Severe mixed bipolar I disorder with psychotic features, mood-congruent
  • Severe mixed bipolar I disorder with psychotic features, mood-incongruent
  • Severe mood disorder with psychotic features
  • Severe mood disorder with psychotic features, mood-congruent

Clinical Classification

Clinical Classifications group individual ICD-10-CM diagnosis codes into broader, clinically meaningful categories. These categories help simplify complex data by organizing related conditions under common clinical themes.

They are especially useful for data analysis, reporting, and clinical decision-making. Even when diagnosis codes differ, similar conditions can be grouped together based on their clinical relevance. Each category is assigned a unique CCSR code that represents a specific clinical concept, often tied to a body system or medical specialty.

Bipolar and related disorders

CCSR Code: MBD003

Inpatient Default: Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.

Outpatient Default: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.

Tabular List of Diseases and Injuries

The following annotation back-references are applicable to this diagnosis code. The Tabular List of Diseases and Injuries is a list of ICD-10-CM codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more.


Inclusion Terms

Inclusion Terms
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
  • Bipolar disorder, current episode mixed with mood-congruent psychotic symptoms
  • Bipolar disorder, current episode mixed with mood-incongruent psychotic symptoms

Index to Diseases and Injuries References

The following annotation back-references for this diagnosis code are found in the injuries and diseases index. The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10-CM code(s).

Index of External Cause of Injuries

References found for this diagnosis code in the External Cause of Injuries Index:

    • Disorder(of)
      • bipolar (I) (seasonal) (type 1)
        • current (or most recent) episode
          • mixed
            • severe (without psychotic features)
              • with psychotic features

Convert F31.64 to ICD-9-CM

Below are the ICD-9 codes that most closely match this ICD-10 code, based on the General Equivalence Mappings (GEMs). This ICD-10 to ICD-9 crosswalk tool is helpful for coders who need to reference legacy diagnosis codes for audits, historical claims, or approximate code comparisons.

Bipol I cur mixed w psy

ICD-9-CM: 296.64

This is a direct match with no additional mapping qualifiers. The absence of a flag generally means the mapping is considered exact or precise. In other words, the ICD-10 code maps cleanly to the ICD-9 code without qualification, approximation, or needing multiple codes.

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 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. It uses a mild electric current and is done while you are under general anesthesia. 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).
    • Repetitive transcranial magnetic stimulation (rTMS), a brain stimulation procedure that uses magnetic waves to relieve depression. It is not as powerful as ECT, but with rTMS, you don't need general anesthesia. It also has a low risk of negative effects on your memory and thinking.
    • Light therapy has been shown to be effective for seasonal affective disorder (SAD). Many people with bipolar disorder also find that their depression gets worse during certain seasons, usually in the fall and winter. Light therapy may help with their symptoms.
    • Healthy lifestyle changes, such as getting regular exercise, having a consistent sleep schedule, and keeping a mood journal, can also help with your symptoms.

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


[Learn More in MedlinePlus]

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.


[Learn More in MedlinePlus]

Code History

  • FY 2026 - No Change, effective from 10/1/2025 through 9/30/2026
  • FY 2025 - No Change, effective from 10/1/2024 through 9/30/2025
  • FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
  • 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. This was the first year ICD-10-CM was implemented into the HIPAA code set.

Footnotes

[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:

  • The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
  • The condition places limitations on self-care, independent living, and social interactions.