Facebook tracking pixel
F32.89
ICD-10-CM
Major Depressive Disorder with Anxious Distress

Find information on Major Depressive Disorder with Anxious Distress including diagnostic criteria, ICD-10-CM code F33.1, DSM-5 criteria 296.2X and 296.3X, clinical documentation requirements, anxiety symptoms in depression, and treatment resources for healthcare professionals. Learn about assessing and coding anxious distress specifier, severity measures, and differential diagnosis considerations for accurate medical billing and quality patient care. Explore resources for mental health providers covering the management and coding of MDD with anxious distress.

Also known as

MDD with Anxious Distress
Depression with Anxiety

Diagnosis Snapshot

Key Facts
  • Definition : Persistent sadness, loss of interest, and impaired function.
  • Clinical Signs : Low mood, fatigue, sleep changes, difficulty concentrating, anxiety.
  • Common Settings : Primary care, outpatient clinics, telehealth, partial hospitalization.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC F32.89 Coding
F32-F33

Major depressive disorder

Characterized by persistent sadness, loss of interest, and other symptoms.

F40-F48

Neurotic, stress-related, and somatoform disorders

Includes anxiety, phobias, obsessive-compulsive disorder, and related conditions.

F41

Anxiety disorders

Covers various anxiety disorders including generalized anxiety and panic disorder.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the diagnosis Major Depressive Disorder?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Major Depression with Anxiety
Generalized Anxiety Disorder
Persistent Depressive Disorder

Documentation Best Practices

Documentation Checklist
  • Major Depressive Disorder Anxious Distress diagnosis documentation:
  • ICD-10-CM F32.x and F41.1 codes documented
  • Symptoms present for at least 2 weeks
  • Depressed mood or anhedonia + 2 anxious distress symptoms
  • Assess impact on functioning, document severity

Coding and Audit Risks

Common Risks
  • Unspecified Anxiety Code

    Coding anxious distress with unspecified anxiety codes instead of the specific MDD with anxious distress code (F33.1) leads to inaccurate severity reflection.

  • Missing Anxious Distress

    Failing to document and code anxious distress features when present in MDD can result in undercoding and missed CC/MCC capture.

  • Inconsistent Documentation

    Discrepancies between physician documentation and coded anxious distress can trigger audits and denials. Clear documentation linking anxiety to MDD is crucial.

Mitigation Tips

Best Practices
  • Screen for anxiety in MDD diagnosis: ICD-10 F32.x, F41.x. CDI: Detailed anxiety symptoms.
  • Document anxiety distress severity: Mild, moderate, severe. DSM-5, HCC coding. Compliance.
  • Assess impact of anxiety on MDD treatment plan. CPT codes, quality measures. Documentation.
  • Target anxiety with evidence-based therapies. CBT, mindfulness. Improve outcomes. Compliance.
  • Monitor anxiety & depression symptoms regularly. Track progress. ICD-10, quality reporting.

Clinical Decision Support

Checklist
  • Depressed mood most of the day, nearly every day?
  • Markedly diminished interest or pleasure?
  • Key anxious distress symptoms: tension, restlessness, impaired concentration due to worry, fear of losing control?
  • Clinically significant distress or impairment?
  • Rule out other medical/mental disorders impacting symptoms?

Reimbursement and Quality Metrics

Impact Summary
  • Major Depressive Disorder Anxious Distress reimbursement impacts coding accuracy, affecting hospital revenue cycle management.
  • Correct F41.8 and associated codes maximize MDD reimbursement, impacting case mix index for hospital reporting.
  • Anxious distress specifier impacts severity level for MDD, influencing quality metrics tied to depression treatment outcomes.
  • Accurate coding, diagnosis, and treatment data crucial for MDD with anxious distress improve quality reporting and value-based care.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes. Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Code F33.x for MDD, add F41.x for anxiety
  • Document severity, frequency, duration
  • Specify anxious distress symptoms clearly
  • Check DSM-5 criteria for accurate diagnosis
  • Link functional impairment to MDD/anxiety

Documentation Templates

Patient presents with symptoms consistent with Major Depressive Disorder with Anxious Distress.  The patient reports persistent sadness, depressed mood, and anhedonia for the past six weeks.  Symptoms include significant weight loss, insomnia, fatigue, feelings of worthlessness, difficulty concentrating, and recurrent thoughts of death, though no specific suicidal plan is reported.  The patient exhibits psychomotor agitation and reports significant anxiety, restlessness, and difficulty relaxing.  These anxious distress symptoms are prominent and impairing, contributing significantly to the overall clinical picture.  The patient denies any history of mania or hypomania.  Symptoms meet DSM-5 criteria for Major Depressive Disorder with Anxious Distress.  Differential diagnoses considered include generalized anxiety disorder, adjustment disorder with depressed mood, and medical conditions that can mimic depression.  Initial treatment plan includes psychotherapy with Cognitive Behavioral Therapy (CBT) techniques focused on mood management and anxiety reduction.  Pharmacotherapy with a selective serotonin reuptake inhibitor (SSRI) is also recommended to address both the depressive and anxiety components.  Patient education provided on medication side effects, potential drug interactions, and the importance of adherence.  Referral to psychiatry for medication management and further evaluation is made.  Follow-up scheduled in two weeks to assess treatment response and adjust the treatment plan as needed.  Prognosis is guardedly optimistic with appropriate treatment and ongoing monitoring of symptoms.  ICD-10 code F32.2, Major Depressive Disorder, single episode, moderate, with anxious distress, is assigned.  CPT codes for evaluation and management, psychotherapy, and pharmacotherapy management will be documented based on the time spent and complexity of the services provided.  Patient's progress and response to treatment will be closely monitored with ongoing assessments of depressive and anxiety symptoms, functional impairment, and suicidal ideation.