Mood Disorder ICD-10 Codes: F30-F39 Family Guide

It’s 5:40 on a Friday. Jordan’s intake is done. PHQ-9 is 14. He said he has been down for years. The claim line still shows last year’s F32.9 because that is what the template dropped in. You still have not asked about hypomania, a prior episode with relief, or whether this is two weeks or two years.

Pick the mood disorder ICD-10 family before you touch a fifth character. A score of 14 does not mean F32.1. “Down for years” does not establish F33. Work the family gate, then use the most specific code supported for this encounter. Unspecified codes have valid uses when greater specificity is not supported; reassess when clinically indicated. See the CMS ICD-10-CM coding guidelines.

If you still need codes outside F30-F39, start with ICD-10 codes for therapists.

Educational content, not clinical or legal advice. ICD-10-CM descriptors, DSM criteria, payer rules, and state scope change. Check current files before you diagnose, code, or bill.

Use official code sources first

Use the CDC ICD-10-CM page for official US diagnosis-code files and guideline updates. Use the CMS ICD-10 page for Medicare coding resources. The American Psychiatric Association DSM overview is the source for the diagnostic framework the codes represent.

Those files do not replace payer policy or your license. They keep you from coding from memory, last year’s template, or a one-line internet list.

Mood disorder ICD-10 family table

F30, F31, F32, F33, and F34 are categories. The billable line is a more specific code. Read the official descriptor, then write the evidence next to it.

Category	Official ICD-10-CM title	Use when the chart supports
F30	Manic episode	The ICD-10-CM manic-episode category. F30 itself is not a reportable final code. A manic episode can meet DSM bipolar I criteria even without a prior bipolar history. See the APA bipolar overview and the CDC ICD-10-CM files.
F31	Bipolar disorder	Bipolar I or II, including current episode, severity, psychotic features, and remission codes.
F32	Depressive episode	Use the applicable ICD-10-CM descriptor when a single-episode depressive formulation is supported.
F33	Major depressive disorder, recurrent	A supported recurrent course after verifying distinct major depressive episodes and episode separation. See the NICE depression recommendations.
F34	Persistent mood [affective] disorders	Cyclothymia (F34.0), dysthymia (F34.1), DMDD (F34.81), or other persistent patterns.
F39	Unspecified mood [affective] disorder	A mood disturbance is supported, and greater specificity is not supported for the encounter. Reassess when clinically indicated. See the CMS ICD-10-CM coding guidelines.

ICD-10-CM does not carry an F38 “other mood disorder” category. If an old WHO table still shows F38, ignore it for US claims.

The code is the index entry. The chart still has to show why that family fits this client today.

Codes therapists actually bill

Most outpatient notes land in a short list. Keep the official descriptor, then write what you heard and observed.

Code	ICD-10-CM descriptor	Use when the chart supports
F32.9	Major depressive disorder, single episode, unspecified	Use when the record supports this descriptor but does not support greater specificity for the encounter. Unspecified codes can be appropriate. See the CMS ICD-10-CM coding guidelines.
F32.0	Major depressive disorder, single episode, mild	First episode, mild symptom load and impairment.
F32.1	Major depressive disorder, single episode, moderate	First episode, moderate symptoms and functional impact.
F32.2	Major depressive disorder, single episode, severe without psychotic features	First episode, severe impairment without psychosis.
F32.3	Major depressive disorder, single episode, severe with psychotic features	First episode with mood-congruent or mood-incongruent psychosis. Coordinate care.
F32.A	Depression, unspecified	Depressive symptoms are present; MDD criteria are not yet established.
F32.81	Premenstrual dysphoric disorder	PMDD criteria are met. Do not use this as a stand-in for PMS.
F33.1	Major depressive disorder, recurrent, moderate	Prior episode plus current moderate severity.
F33.0	Major depressive disorder, recurrent, mild	Recurrent course, mild current episode.
F33.2	Major depressive disorder, recurrent, severe without psychotic features	Recurrent course, severe current episode without psychosis.
F33.9	Major depressive disorder, recurrent, unspecified	A recurrent formulation is supported, while greater current specificity is not supported.
F34.1	Dysthymic disorder	Persistent low-grade depression meeting duration and associated-symptom rules.
F34.0	Cyclothymic disorder	Use the current ICD-10-CM descriptor and diagnostic manual when the supported formulation is cyclothymic disorder.
F34.81	Disruptive mood dysregulation disorder	Childhood or adolescent presentation with severe temper outbursts and persistent irritability.
F31.81	Bipolar II disorder	At least one hypomanic episode and one major depressive episode, without a manic episode.
F31.32	Bipolar disorder, current episode depressed, moderate	Bipolar I, current moderate depression.
F31.9	Bipolar disorder, unspecified	Bipolar spectrum is supported; type or current episode is not yet specified.
F39	Unspecified mood [affective] disorder	Mood disturbance is supported, but greater specificity is not supported for the encounter.

Code coexisting established conditions relevant to the encounter and follow all code-set inclusion, exclusion, and sequencing instructions. Do not add F39 merely to acknowledge a better-supported diagnosis. See the CMS ICD-10-CM coding guidelines and the CDC ICD-10-CM files.

Start with the family gate

Do not pick F32.1 from a PHQ-9 of 14. Work the family checks first.

1. Name the organizing problem. Is the disturbance primarily mood, or is mood secondary to trauma, anxiety, substance use, ADHD, or a medical condition?
2. Screen for lifetime mania and hypomania, then review the current diagnostic manual and relevant exclusions before selecting a bipolar code. See the APA bipolar overview and the CMS ICD-10-CM coding guidelines.
3. Review the episode history with the current diagnostic manual before choosing F33. A prior period of sadness alone does not establish recurrent MDD. See the NICE depression recommendations.
4. Time the current picture. Two weeks is the usual MDD duration floor. Two years is the usual adult dysthymia floor. A stressor inside three months opens the adjustment disorder ICD-10 branch.
5. Show clinical significance. Name work, school, relationships, sleep, self-care, or daily responsibilities in observable terms.
6. Pressure-test psychosis, mixed features, and risk. Severe codes and safety planning need that evidence in the same note.
7. Use the most specific diagnosis supported by the record for this encounter. Unspecified codes have valid uses when greater specificity is not supported. Reassess when clinically indicated. See the CMS ICD-10-CM coding guidelines.

If those gates fail, stop. An anxiety, trauma-related, adjustment, substance, or medical code may be the honest line.

Dana, an LPC closing Friday claims, ran this fictional example on Jordan. Hypomania screen negative. The history and symptom assessment were incomplete. She used the code supported by the encounter and documented what remained to assess.

F32.9 versus F32.A

These two codes get swapped more than any other pair in this block.

Use F32.9 only when the record supports its descriptor and greater specificity is not supported for the encounter. Use the current diagnostic manual and the applicable ICD-10-CM descriptor; a PHQ-9 score does not establish the diagnosis or severity by itself. See the CMS ICD-10-CM coding guidelines and the NICE depression recommendations.

F32.A is depression, unspecified. Use it when depressive symptoms are present but the record does not support a more specific diagnosis for the encounter. Do not turn a screening score into an automatic code decision. Reassess when clinically indicated. See the CMS ICD-10-CM coding guidelines.

F39 is broader still. Use it only when a mood disturbance is supported and greater specificity is not supported for the encounter. Do not choose it by default when a more specific supported diagnosis is available. Reassess when clinically indicated. See the CMS ICD-10-CM coding guidelines.

Single episode, recurrent, or persistent

F32 versus F33 is a history question. The current episode can look identical.

A defensible recurrent code requires a supported recurrent formulation under the current diagnostic manual. “Chronic depression” is not automatically F33. Verify the episode history before choosing the recurrent family. See the NICE depression recommendations.

For persistent depressive disorder, document the course and use the current diagnostic manual and ICD-10-CM descriptor. Code coexisting established conditions relevant to the encounter and follow all code-set inclusion, exclusion, and sequencing instructions. See the CMS ICD-10-CM coding guidelines and the CDC ICD-10-CM files.

F32.81 is not a mood-family shortcut for any premenstrual complaint. Keep it for a PMDD formulation.

If the client is a child with severe temper outbursts and persistent irritability, look at F34.81 rather than stretching an adult F33 line.

Severity, psychosis, and remission

Once the family is right, the next character is a severity or course call, not a score call.

Mild, moderate, and severe should match symptom load and impairment together. A screening score is one input, not the diagnosis. Write the function: missed shifts, stalled self-care, stalled decisions, or collapsed sleep.

Psychotic-feature codes (F32.3, F33.3, F31.2, F31.5, and related lines) need hallucinations, delusions, or other psychotic symptoms in the record, plus a plan for psychiatric collaboration. Notes that say “severe” because the client is crying hard do not support those codes.

If remission is being considered, document the current course and apply the current diagnostic manual and ICD-10-CM descriptor rather than relying on a short-term improvement.

The bipolar gate therapists miss

A mood disorder ICD-10 chart that never asks about elevated or irritable mood, decreased need for sleep, racing thoughts, or impulsive spending will over-assign F32 and F33.

F30 is the ICD-10-CM manic-episode category, not a reportable final code. Review the current diagnostic manual and the supported formulation before selecting a bipolar code. See the APA bipolar overview and the CDC ICD-10-CM files.

F34.0 cyclothymia is the chronic, subthreshold swing pattern. F34.81 DMDD is a child and adolescent diagnosis built on severe temper outbursts and persistent irritability, not an adult “mood swings” label.

When mania, mixed features, or psychosis is in play, document risk, sleep, substances, and the referral or collaboration step in the same note.

For how DSM language maps onto claim codes without collapsing the two systems, use the DSM-5 to ICD-10 crosswalk.

Adjacent diagnoses the chart has to name

A low-mood week can sit next to several other codes. Name the fork in the note.

Adjustment disorder with depressed mood is an adjacent branch when the documented presentation supports it; a stressor does not automatically demote MDD to adjustment disorder.

Generalized anxiety disorder is an adjacent branch when the documented presentation supports it. The anxiety ICD-10 codes guide holds that table.

Post-traumatic stress disorder is an adjacent F43.1 branch. Numbness, sleep disruption, and anhedonia do not automatically establish a mood-family code.

Substance, medication, and medical contributors can mimic energy change, irritability, or sleep collapse. Document the review even when the conclusion is brief.

Documentation crosswalk

Mood disorder ICD-10 codes hold up better when the note answers the reviewer’s basic questions before the claim leaves the practice.

Chart element	What to document	Why it matters
Mood pattern	Depressed mood, anhedonia, elevated or irritable mood, mixed features, or persistent low-grade mood	Selects the family.
Episode history	Relevant prior history or a continuous persistent course	Supports selection among F32, F33, and F34.
Symptom count and duration	Document the current diagnostic-manual criteria and applicable code-set descriptors	Supports the descriptor.
Functional impairment	Missed work, school drop-off, relationship strain, sleep collapse, reduced self-care, or stalled decisions	Supports medical necessity.
Severity or course	Mild, moderate, severe, psychotic features, partial remission, full remission, or unspecified	Selects the next character.
Differential reasoning	Bipolar spectrum, adjustment disorder, PTSD, GAD, substance, medication, thyroid or other medical contributors	Shows you considered likely alternatives.
Risk and safety	Suicidal ideation, self-harm, reckless mania, aggression, or care avoidance	Documents acuity and treatment intensity.
Treatment-plan link	Behavioral activation, cognitive work, sleep routine, interpersonal repair, safety planning, or referral	Connects the code to active care.

A concise note can still be strong. It names the pattern, the impairment, the intervention, the client response, and the plan.

Treatment-plan and medical-necessity language

A diagnosis code does not prove medical necessity by itself. The treatment record does that work.

For mood-family care, tie the documented diagnosis to functional targets such as restoring a morning routine, resuming avoided activities, reducing missed workdays, completing a sleep window, or tracking a validated measure alongside clinical findings. The code should reflect the evidence supported for the encounter. Unspecified codes can remain appropriate when greater specificity is not supported; reassess when clinically indicated. See the CMS ICD-10-CM coding guidelines.

The progress note then carries the same thread: intervention, response, homework, risk changes, and the next clinical step. If the picture widens into hypomania, psychosis, or a trauma-led formulation, the note should say whether the family still fits.

Mood disorder ICD-10 workflow for the chart

1. Start with the clinical presentation, not the code list.
2. Screen mania, hypomania, psychosis, substances, medical contributors, trauma, and risk.
3. Confirm the family gate before any severity character.
4. Pick the most specific supported code in F30-F39.
5. Link the supported code to treatment-plan targets and reassess when clinically indicated.
6. Carry the same thread into each progress note.
7. Use the most specific supported code, or document why an unspecified code still fits this encounter. See the CMS ICD-10-CM coding guidelines.