Find information on Major Depressive Disorder Recurrent Episode, including clinical documentation requirements, ICD-10-CM code F33.x, DSM-5 criteria, and treatment guidelines. Learn about accurate medical coding for MDD recurrent episodes for healthcare professionals, mental health billing, and proper diagnosis coding. Explore resources for managing recurrent depression in clinical settings and ensuring compliant documentation.
Also known as
Depressive Episodes
Covers various depressive disorders, including recurrent episodes.
Mood Affective Disorders
Encompasses all mood disorders, including major depression.
Mental, Behavioral Disorders
Broad category containing all mental and behavioral disorders.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the diagnosis Major Depressive Disorder?
Yes
Is this a recurrent episode?
No
Do NOT code as MDD. Review alternate diagnoses.
When to use each related code
| Description |
|---|
| Major depression, more than one episode |
| Single major depressive episode |
| Persistent depressive disorder (dysthymia) |
Coding MDD recurrent episode without specifying single or recurrent episode type (mild, moderate, severe, with psychotic features, in partial or full remission) leads to inaccurate severity and payment.
Lack of sufficient documentation to support the diagnosis of recurrent MDD can lead to coding errors, denials, and compliance issues.
Failure to accurately code comorbid conditions like anxiety or substance use disorders with recurrent MDD can impact clinical care and reimbursement.
Q: How to differentiate Major Depressive Disorder Recurrent Episode from persistent depressive disorder (dysthymia) in clinical practice?
A: Differentiating Major Depressive Disorder, Recurrent Episode, from Persistent Depressive Disorder (Dysthymia) requires careful assessment of symptom duration and intensity. While both involve depressed mood, MDD Recurrent Episode presents as distinct episodes of at least two weeks with more severe symptoms like anhedonia, significant weight changes, sleep disturbances, and suicidal ideation. These episodes are interspersed with periods of remission. Dysthymia, on the other hand, involves a chronically depressed mood lasting for at least two years, with less intense symptoms that may not meet the full criteria for a major depressive episode. However, individuals with dysthymia can experience superimposed major depressive episodes, sometimes referred to as "double depression." Accurate diagnosis relies on thorough history taking, including symptom timelines, severity assessment using standardized scales like the PHQ-9, and consideration of functional impairment. Explore how integrating validated assessment tools can enhance diagnostic accuracy in your practice.
Q: What are evidence-based first-line treatment options for Major Depressive Disorder Recurrent Episode beyond initial presentation?
A: Evidence-based first-line treatment for Major Depressive Disorder, Recurrent Episode, after the initial presentation, often involves a combination of pharmacotherapy and psychotherapy. Specifically, Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) remain common first-line medications, with selection influenced by individual patient factors, including comorbid conditions and prior treatment response. Cognitive Behavioral Therapy (CBT) and Interpersonal Therapy (IPT) have strong empirical support and can be offered concurrently with medication or as stand-alone treatments for milder cases. For patients with inadequate response to initial treatments, consider implementing augmentation strategies, such as adding bupropion, switching to another antidepressant class, or exploring adjunctive therapies like lithium or atypical antipsychotics. Learn more about personalized treatment approaches for managing recurrent MDD based on individual patient needs and preferences.
Patient presents with a recurrent major depressive episode, fulfilling DSM-5 diagnostic criteria for Major Depressive Disorder, Recurrent Episode. Symptoms, present for over two weeks, include depressed mood, anhedonia, significant weight loss without dieting, insomnia, fatigue, feelings of worthlessness, diminished concentration, and recurrent thoughts of death, though no specific suicidal ideation or plan was reported. Patient reports a past history of major depressive episodes, with the most recent episode occurring approximately two years ago, successfully treated with psychotherapy and pharmacotherapy. Current episode onset is reported as approximately three weeks ago, precipitated by significant work-related stress and interpersonal conflict. Patient denies current substance use and medical history is significant for hypothyroidism, well-controlled with levothyroxine. Mental status examination reveals a patient who appears tired and tearful, with psychomotor retardation. Affect is constricted and mood is depressed. Thought content is preoccupied with feelings of hopelessness and failure. Insight and judgment appear intact. Diagnosis of Major Depressive Disorder, Recurrent Episode is supported by clinical presentation, symptom duration, and history. Treatment plan includes initiation of sertraline 50mg daily, titrating as needed, combined with cognitive behavioral therapy (CBT) focusing on stress management and coping skills. Patient education provided on medication side effects, potential drug interactions, and the importance of medication adherence. Referral to a psychiatrist for further evaluation and medication management is recommended. Patient safety assessed, and deemed low risk at this time. Follow-up appointment scheduled in two weeks to monitor symptom response to treatment and assess for medication efficacy and tolerability. Prognosis guardedly optimistic given patient's history of successful treatment. ICD-10 code F33.1 is assigned for Major Depressive Disorder, Recurrent Episode.