Find information on Major Depressive Disorder Recurrent Severe with Psychotic Features, including clinical documentation, diagnostic criteria, medical coding (ICD-10-CM F33.2), and treatment options. Learn about the symptoms of severe depression with psychosis, differential diagnosis, and best practices for healthcare professionals. Explore resources for managing recurrent major depression and psychotic symptoms in severe cases. This resource provides valuable insights for accurate diagnosis and effective treatment strategies.
Also known as
Major depressive disorder, recurrent
Recurring episodes of major depression.
Major depressive disorder, recurrent, severe
Severe recurring depressive episodes, possibly with psychotic features.
Major depressive disorder, single episode
A single, distinct episode of major depression.
Organic mood disorder
Mood disturbances due to a medical condition.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the diagnosis Major Depressive Disorder?
Yes
Is it recurrent (prior episode)?
No
Not Major Depressive Disorder. Review other diagnoses.
When to use each related code
| Description |
|---|
| Major Depression, Recurrent, Severe with Psychosis |
| Major Depressive Disorder, Recurrent, Severe |
| Major Depressive Disorder, Single Episode, Severe with Psychosis |
Coding psychosis without specific documentation of delusions or hallucinations risks downcoding and lost revenue.
Inaccurate documentation of severe symptoms can lead to incorrect coding of mild or moderate depression, impacting reimbursement.
Lack of clear documentation of previous depressive episodes can lead to coding as a single episode, affecting severity and payment.
Patient presents with a recurrent major depressive episode characterized by severe symptoms and psychotic features, meeting DSM-5 criteria for Major Depressive Disorder, Recurrent, Severe with Psychotic Features (296.34). The patient reports persistent and pervasive depressed mood, anhedonia, significant weight loss, insomnia, psychomotor retardation, fatigue, feelings of worthlessness, diminished concentration, and recurrent suicidal ideation with intent. Psychotic symptoms include auditory hallucinations consistent with depressive themes and delusions of guilt. The patient's current episode represents a relapse following a period of relative remission after previous treatment for major depression. Symptoms have been present for the past six weeks and are significantly impacting social and occupational functioning, resulting in job loss and social withdrawal. The patient's medical history includes hypertension managed with medication. Family history is positive for mood disorders. Substance use is denied. Mental status examination reveals a disheveled appearance, flat affect, and psychomotor retardation. Insight and judgment appear impaired. Differential diagnosis includes Bipolar Disorder with Psychotic Features, Schizoaffective Disorder, and other medical conditions that can mimic depression. A comprehensive medical evaluation is recommended to rule out organic causes. Initial treatment plan includes hospitalization for safety and stabilization, initiation of antidepressant medication with antipsychotic augmentation, and individual psychotherapy focused on cognitive behavioral therapy (CBT) and management of psychotic symptoms. Prognosis guarded given the severity and recurrent nature of the illness. Close monitoring of symptoms, medication adherence, and suicidal ideation is warranted. Regular follow-up appointments scheduled to assess treatment response and adjust treatment plan as needed. Current treatment plan aims to achieve remission of depressive and psychotic symptoms, improve functional status, and prevent future relapse. Coding considerations include ICD-10 code 296.34 and appropriate CPT codes for evaluation and management, psychotherapy, and pharmacologic management.