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What are the depression ICD-10 codes?

What are the depression ICD-10 codes

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Depression ICD-10 Codes: F32 & F33 Explained

A practical, visual reference for clinicians: the most-used codes, how to pick the right specificity, ICD vs DSM tips, exclusions to watch, and real-world examples for cleaner charts and fewer denials.

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Quick context

How ICD-10 organizes depressive disorders

ICD-10 groups depressive disorders into two major families: F32 (single depressive episode) and F33 (recurrent depressive disorder). Severity is specified as mild, moderate, or severe, with an option to indicate with or without psychotic symptoms for severe episodes.

F32 — Single depressive episodes

Use F32 codes when the current presentation is a first-time or single episode. The core symptom cluster includes lowered mood, reduced energy/activity, anhedonia, diminished concentration, sleep/appetite disturbance, and reduced self-esteem; severity is determined by the number and impact of symptoms.

F32.0 Mild depressive episode
  • Typically 2–3 core symptoms with distress but preserved basic functioning.
  • Document functional examples (e.g., reduced productivity, social withdrawal).
F32.1 Moderate depressive episode
  • Four or more symptoms with significant difficulty maintaining ordinary activities.
  • Track symptom measures (e.g., PHQ-9) to show medical necessity.
F32.2 Severe without psychotic symptoms
  • Marked impairment, often with psychomotor changes, diurnal variation, guilt/worthlessness.
  • No delusions or hallucinations present.
F32.3 Severe with psychotic symptoms
  • Severe episode with mood-congruent or incongruent psychotic features.
  • Coordinate with medication management/psychiatry; safety plan and risk documentation required.
F32.9 Depressive episode, unspecified
  • Use temporarily when details are insufficient; refine once data are complete.
  • Include a plan (e.g., collateral, labs, rating scales, follow-up) to increase specificity.

F33 — Recurrent depressive disorder

Use F33 codes when there are repeated episodes of depression (with no independent history of mania). Code severity for the current episode; severe episodes can be specified as with/without psychotic symptoms.

F33.0 Recurrent — current episode mild

Meets mild threshold; previous episodes documented. No manic history. Capture residual symptoms and functioning between episodes.

F33.1 Recurrent — current episode moderate

Four or more symptoms and notable functional interference. Include longitudinal context and response to prior treatments.

F33.2 Recurrent — current episode severe without psychosis

Severe symptom burden with no psychotic features. Risk assessment, level-of-care justification, and safety planning should be explicit.

F33.3 Recurrent — current episode severe with psychosis

Psychotic features present. Coordinate with psychiatry; document rationale for medication, monitoring, and care transitions if needed.

F33.9 Recurrent depressive disorder, unspecified

Temporary placeholder when episode severity or psychotic status is unclear. Add a plan to obtain specificity (e.g., collateral, repeat measures).

ICD vs DSM — quick comparison (cards)

ICD-10: F32

Single Depressive Episode

Use when this is the first or only episode documented. Code current severity (mild / moderate / severe ± psychosis).

DSM-5 mapping: Major Depressive Episode (single), specify severity & features.
ICD-10: F33

Recurrent Depressive Disorder

Use when there are repeated episodes without manic history. Code the severity of the current episode.

DSM-5 mapping: Major Depressive Disorder, recurrent; add specifiers as appropriate.
DSM-5

Criteria & Specifiers

DSM-5 provides the diagnostic criteria (duration, symptoms, impairment) and specifiers (e.g., anxious distress, melancholic).

Use DSM-5 to justify the selected ICD-10 billing code in your note.

Exclusions & coding cautions

Rule out bipolar spectrum (F31.-) if mania/hypomania present Substance/medication-induced mood disorder Mood disorder due to another medical condition Specify psychotic features when present

Real-world coding examples

First episode, moderate severity
PHQ-9 = 14, anhedonia, low mood, fatigue, morning worsening; no psychosis; no manic history.
ICD-10: F32.1 (Moderate)
Chart cue: document functional impacts and sleep/appetite changes.
Recurrent severe without psychosis
Multiple prior episodes; current PHQ-9 = 21, psychomotor retardation; no delusions/hallucinations.
ICD-10: F33.2 (Severe, no psychosis)
Chart cue: include risk assessment and care plan (e.g., med review, safety plan).
Recurrent severe with psychosis
Mood-congruent delusions; impaired functioning; prior similar episode.
ICD-10: F33.3 (Severe with psychosis)
Chart cue: coordinate with psychiatry; document rationale for LOC and monitoring.

Depression coding workflow (at a glance)

Pair the chosen ICD code with DSM-5 criteria justification, functional examples, measures (PHQ-9), and a clear treatment plan.

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Frequently asked questions

What’s the difference between F32 and F33?
F32 is used for a single depressive episode; F33 is for recurrent depressive disorder. Code severity for the current episode in both families.
When do I consider bipolar (F31.-) instead?
If there is any history of independent mania or hypomania, the diagnosis shifts to bipolar spectrum and depressive episodes fall under F31.- coding.
Do I need to add specifiers like “with anxious distress”?
Specifiers live in DSM-5 (for clinical description). ICD-10 codes capture episode and severity ± psychosis. Document DSM-5 specifiers in the note text.
Can I code depression with anxiety together?
Yes—if criteria for both are met. Add the appropriate anxiety code (e.g., F41.1) and describe functional impact of each condition.
Is F32.9/F33.9 acceptable for billing?
Usually acceptable but not ideal. Payers prefer specificity. Use “unspecified” as a temporary label and plan to refine quickly.
What documentation supports medical necessity?
Severity (e.g., PHQ-9), functional impairment, risk assessment, and treatment response over time are key elements for payers and audits.
How often should I update the code?
Update when episode status or severity changes (e.g., remission, recurrence, psychotic features). Align code with the current clinical picture.
Where can I learn more?
See WHO ICD resources and your payer policies. For documentation technique, review our guides on treatment planning, SOAP notes, progress notes, intake, and discharge.

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