For healthcare professionals, the use of the ICD-10 coding system ensures that diagnoses are both accurate and standardized.
Whether you’re a healthcare provider, coder, or insurance professional, understanding diagnosis codes for depression is essential for ensuring proper diagnosis, treatment, and reimbursement.
In this guide, we’ll explore the key ICD-10 codes for depression, specifically the codes for Major Depressive Disorder (MDD), both single episode and recurrent (F32.0–F33.3).
Additionally, we’ll look at recent updates to these codes for 2025, providing a comprehensive overview of how clinicians can accurately document and code depressive disorders.
What is ICD-10 Coding for Depression?
ICD-10 stands for the International Classification of Diseases, 10th Revision. It’s a standardized system used globally for classifying diseases, disorders, and other health conditions.
In the United States, healthcare providers use ICD-10-CM (Clinical Modification) for diagnosis coding, while ICD-10-PCS (Procedure Coding System) is used for hospital inpatient procedures.
When it comes to depression, ICD-10 codes help clinicians, insurance companies, and healthcare systems:
- Accurately diagnose and classify different types and severities of depression
- Process insurance claims and determine reimbursement
- Track health statistics and trends at population levels
- Facilitate research on depression prevalence and treatment outcomes
The ICD-10 system provides specific codes for various depressive disorders, primarily in the F32 and F33 categories, which correspond to Major Depressive Disorder, Single Episode and Major Depressive Disorder, Recurrent, respectively.
These codes are essential for ensuring proper documentation, communication between healthcare providers, and appropriate patient care.
2025 Updates to ICD-10 Depression Codes
The ICD-10-CM code set is updated annually by the Centers for Medicare & Medicaid Services (CMS) and the National Center for Health Statistics (NCHS), with changes typically taking effect on October 1 each year.
For 2025, the updates became effective on October 1, 2024.
These updates typically include:
- New codes for emerging conditions or more specific classifications
- Revised code descriptions to improve clarity
- Changes to coding guidelines and instructions
- Updates to inclusion and exclusion notes
While specific changes to depression codes for 2025 may be minimal compared to previous years, clinicians and coders need to stay informed about any modifications.
For the 2025 edition, there may be refinements to how certain depressive episodes are classified or documented, particularly regarding specifiers like severity levels, psychotic features, and remission status.
Clinicians and practice owners should review the latest CMS/WHO documentation to ensure they’re using the most current codes and following updated guidelines.
It’s worth noting that there were no major coding changes to ICD-10 Depression codes for 2025; the existing codes for major depressive disorder (F32.x, F33.x) were in place, but the specific diagnosis would be based on severity, episode type (single or recurrent), and remission status.
The American ICD-10-CM version of codes became effective on October 1, 2024.
Complete List of ICD-10 Codes for Depression (F32.0–F33.3)
Here’s a comprehensive table of ICD-10 codes for depression disorders:
| Code | Description | Clinical Notes |
| F32 – Major Depressive Disorder, Single Episode | ||
| F32.0 | Major depressive disorder, single episode, mild | Characterized by few, if any, symptoms beyond the minimum required for diagnosis. Mild impairment in functioning. |
| F32.1 | Major depressive disorder, single episode, moderate | Symptoms or functional impairment between mild and severe. |
| F32.2 | Major depressive disorder, single episode, severe without psychotic features | Multiple symptoms beyond minimum requirements, marked impairment in functioning, no psychotic features. |
| F32.3 | Major depressive disorder, single episode, severe with psychotic features | Severe depression with delusions or hallucinations. |
| F32.4 | Major depressive disorder, single episode, in partial remission | Symptoms of depression are present but no longer meet full criteria for a major depressive episode. |
| F32.5 | Major depressive disorder, single episode, in full remission | No significant signs or symptoms of depression present for at least 2 months. |
| F32.89 | Other specified depressive episodes | Includes atypical features of depression. |
| F32.9 | Major depressive disorder, single episode, unspecified | Used when the provider doesn’t specify the type, severity, or other details. |
| F33 – Major Depressive Disorder, Recurrent | ||
| F33.0 | Major depressive disorder, recurrent, mild | Recurrent episodes with mild symptoms and impairment. |
| F33.1 | Major depressive disorder, recurrent, moderate | Recurrent episodes with moderate symptoms and impairment. |
| F33.2 | Major depressive disorder, recurrent, severe without psychotic features | Recurrent episodes with severe symptoms but no psychotic features. |
| F33.3 | Major depressive disorder, recurrent, severe with psychotic features | Recurrent episodes with severe symptoms and psychotic features. |
| F33.40 | Major depressive disorder, recurrent, in remission, unspecified | Previous episodes but currently in remission, type not specified. |
| F33.41 | Major depressive disorder, recurrent, in partial remission | Symptoms present but don’t meet full criteria for a major depressive episode. |
| F33.42 | Major depressive disorder, recurrent, in full remission | No significant signs or symptoms for at least 2 months. |
This table provides a quick reference for clinicians and coders to identify the appropriate ICD-10 code based on the patient’s specific conditions/presentation of depression.
This helps to get proper reimbursement of major depressive Disorder, Recurrent, Moderate depression conditions.
Clinical Guidelines for Coding Depression
When coding for depression, following clinical guidelines is essential to ensure accuracy and proper reimbursement.
Here are key considerations:
When to Use Unspecified vs. Specific Severity Codes
Unspecified ICD-10 codes for depression like F32.9 should only be used when the clinician doesn’t have enough information to assign a more specific code.
This might occur in initial encounters before a complete assessment is done, or when documentation is insufficient. However, best practice is to use the most specific code possible based on the clinician’s assessment and documentation.
On the other hand, specific severity codes (mild, moderate, severe) should be used whenever the documentation supports them. These codes provide more clinical detail and can impact treatment decisions and insurance coverage.
| ICD-10 Code for Depression (Specified) | ICD-10 Code for Depression (Unspecified) |
| Used when the clinician has gathered enough clinical detail to assign a specific severity level (mild, moderate, or severe) or other defining features to the depressive episode. | Used when critical diagnostic information is unknown or the condition doesn’t fit standard diagnostic categories.
|
Documentation Requirements for Payers
Insurance payers typically require documentation that includes:
- Specific symptoms meeting diagnostic criteria for depression
- Duration of symptoms
- Severity assessment
- Functional impairment
- Any relevant specifiers (with or without psychotic features, remission status)
- Treatment plan and response to treatment
Without proper documentation, claims may be denied or require additional information for processing.
Common Mistakes in Depression Coding
- Coding dysthymia as major depression: Persistent depressive disorder (dysthymia) has its own code (F34.1) and should not be coded with F32 or F33 codes.
- Using adjustment disorder codes when major depression is present: Adjustment disorder with depressed mood (F43.21) is different from major depressive disorder and should only be used when the depression is in response to an identifiable stressor and doesn’t meet full criteria for MDD.
- Failing to specify recurrent vs. single episode: This distinction is clinically important and affects code selection (F32 vs. F33).
- Not documenting severity level: When severity is documented in the clinical record but not reflected in the code, it can lead to inaccurate coding and potential payment issues.
- Missing psychotic features: When psychotic features are present, using codes without this specifier (e.g., F32.2 instead of F32.3) can result in inappropriate treatment plans.
ICD-10 vs. DSM-5 Depression Criteria
Understanding the relationship between ICD-10 and DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) is crucial for mental health professionals.
While both systems are used to diagnose depression, they serve different purposes and have some distinctions.
DSM-5 Depression Criteria
The DSM-5 provides the clinical criteria for diagnosing Major Depressive Disorder:
- At least five of nine specific symptoms present during the same 2-week period
- Symptoms must include either depressed mood or loss of interest/pleasure
- Symptoms cause clinically significant distress or impairment
- Episode not attributable to substances or another medical condition
- No history of manic or hypomanic episodes
The DSM-5 also includes specifiers for severity, psychotic features, and remission status, which align closely with ICD-10 coding options.
ICD-10 Coding System
ICD-10, on the other hand, is primarily a coding system used for:
- Billing and insurance reimbursement
- Health statistics and epidemiological tracking
- Classification of diseases for administrative purposes
While ICD-10 includes diagnostic criteria, they are generally less detailed than those in DSM-5.
Mapping DSM-5 to ICD-10 Codes
Here’s how DSM-5 depression diagnoses typically map to ICD-10 codes:
| DSM-5 Diagnosis | ICD-10 Code |
| Major Depressive Disorder, Single Episode, Mild | F32.0 |
| Major Depressive Disorder, Single Episode, Moderate | F32.1 |
| Major Depressive Disorder, Single Episode, Severe | F32.2 or F32.3 (with psychotic features) |
| Major Depressive Disorder, Single Episode, In Partial Remission | F32.4 |
| Major Depressive Disorder, Single Episode, In Full Remission | F32.5 |
| Major Depressive Disorder, Recurrent, Mild | F33.0 |
| Major Depressive Disorder, Recurrent, Moderate | F33.1 |
| Major Depressive Disorder, Recurrent, Severe | F33.2 or F33.3 (with psychotic features) |
| Major Depressive Disorder, Recurrent, In Remission | F33.41 or F33.42 |
Clinicians should document according to DSM-5 criteria while ensuring that the documentation supports the specific ICD-10 code selected for billing purposes.
Differential & Related Diagnoses
When coding for depression, it’s important to distinguish it from other related conditions.
Here are some key differential diagnoses and their ICD-10 codes:
Adjustment Disorders with Depression
Adjustment disorders occur in response to an identifiable stressor and don’t meet the full criteria for major depressive disorder.
- F43.21: Adjustment disorder with depressed mood
- F43.22: Adjustment disorder with anxiety
- F43.23: Adjustment disorder with mixed anxiety and depressed mood
These codes should be used when the depressive symptoms are directly tied to a stressor and are less severe or persistent than major depression.
Anxiety Disorders
Depression and anxiety often co-occur, but they have distinct diagnostic codes:
- F41.1: Generalized anxiety disorder
- F41.9: Anxiety disorder, unspecified
When both conditions are present, both codes should be reported.
Bipolar Disorder
Bipolar disorder involves episodes of depression alternating with mania or hypomania:
- F31.0-F31.9: Bipolar disorder (various specifiers)
It’s crucial to distinguish unipolar depression (F32, F33) from bipolar depression, as treatment approaches differ significantly.
Suicidal Ideation
When suicidal ideation is present in addition to depression:
- R45.851: Suicidal ideation
This code should be reported in addition to the depression code to capture the full clinical picture.
Postpartum Depression
Postpartum depression is coded differently based on timing and severity:
- F53.0: Postpartum depression (when it meets criteria for major depression and occurs within 4-6 weeks postpartum)
- F32.x: Major depressive disorder, single episode (with appropriate severity specifier) when occurring outside the immediate postpartum period
For peripartum onset, the provider should document this condition, and code F32.x with the appropriate severity specifier should be used.
Examples of ICD-10 Depression Coding in Practice
To illustrate how ICD-10 depression coding works in real clinical scenarios, let’s examine some examples:
Example 1: Initial Diagnosis
A patient presents with a two-week history of depressed mood, anhedonia, decreased energy, poor concentration, and feelings of worthlessness. Symptoms are causing moderate difficulty in work functioning. No history of prior depressive episodes. No psychotic features noted.
- Correct Coding: F32.1 (Major depressive disorder, single episode, moderate)
- Incorrect Coding: F32.9 (Major depressive disorder, single episode, unspecified) – This would be incorrect because the documentation clearly indicates moderate severity.
Example 2: Recurrent Depression with Psychotic Features
A patient with a history of two prior major depressive episodes now presents with severe depressive symptoms including mood-congruent delusions of guilt and worthlessness. Significant impairment in self-care and functioning. The patient reports auditory hallucinations telling her she is worthless.
- Correct Coding: F33.3 (Major depressive disorder, recurrent, severe with psychotic features)
- Incorrect Coding: F33.2 (Major depressive disorder, recurrent, severe without psychotic features) – This would miss the important clinical detail of psychotic features.
Example 3: Insurance Claim Example
A patient with recurrent major depression, currently in partial remission, is continuing outpatient therapy and medication management.
Insurance Claim Information:
- Primary Diagnosis: F33.41 (Major depressive disorder, recurrent, in partial remission)
- Secondary Diagnosis: Z79.899 (Other long-term (current) drug therapy – for antidepressant medication)
- Procedure Codes: 90837 (Psychotherapy, 60 minutes) and 99214 (Established patient outpatient visit)
This claim accurately reflects the patient’s current status and the services provided, increasing the likelihood of proper reimbursement.
Depression Statistics & ICD-10 Coding Trends
Understanding the prevalence and impact of depression helps contextualize the importance of accurate ICD-10 coding:
US Prevalence of Depression
According to recent data from the National Institute of Mental Health:
- Approximately 21 million adults in the US (8.4% of the adult population) had at least one major depressive episode in the past year
- Depression is more common in females (10.5%) than males (6.2%)
- The prevalence was highest among adults aged 18-25 (17.0%)
How ICD-10 Data is Used in Public Health
ICD-10 coding data serves several important public health functions:
- Tracking Disease Burden: ICD-10 codes help quantify the impact of depression on healthcare systems and society
- Resource Allocation: Health departments use this data to determine where to direct mental health resources
- Research: Researchers analyze ICD-10 data to identify trends, risk factors, and treatment outcomes
- Policy Development: Policymakers use depression statistics to inform mental health legislation and programs
- Quality Improvement: Healthcare organizations analyze coding data to evaluate the effectiveness of depression treatment protocols
Recent trends in ICD-10 coding for depression show increased specificity in documentation and coding, reflecting a greater understanding of depression’s various presentations and the importance of accurate coding for appropriate treatment and reimbursement.
Treatment Documentation & Coding Impact
The relationship between depression treatment and coding is bidirectional – treatment affects documentation, which in turn affects coding.
How Therapy, Medication, or Hospitalizations Affect Coding
Different treatment approaches may influence how depression is coded:
- Outpatient Therapy: Regular outpatient therapy typically uses codes F32.x or F33.x with appropriate severity and remission specifiers. Documentation should show the relationship between treatment and symptom improvement
- Medication Management: When medication is prescribed, additional codes may be needed (e.g., Z79.899 for long-term drug therapy). Changes in medication regimens should be documented, especially if they relate to changes in depression severity
- Hospitalization: Inpatient care for depression often indicates severe symptoms (F32.2, F32.3, F33.2, F33.3). Discharge summaries should clearly document the severity at admission and any improvement by discharge
- Other Treatments: Electroconvulsive therapy (ECT) or transcranial magnetic stimulation (TMS) typically indicate treatment-resistant depression. These treatments should be documented with procedure codes in addition to diagnosis codes
Linking Treatment Plans to ICD-10 Documentation
To ensure accurate coding, treatment plans should:
- Reflect the Specific Diagnosis: Treatment should align with the specific type and severity of depression coded
- Address Documented Symptoms: The treatment plan should target the specific symptoms documented in the assessment
- Include Progress Notes: Regular updates on symptom improvement or worsening support changes in coding (e.g., moving from severe to moderate, or entering remission)
- Document Treatment Response: How the patient responds to treatment provides evidence for the accuracy of the initial diagnosis and code selection
When treatment plans and ICD-10 codes are well-aligned, it creates a clear clinical picture that supports appropriate care and reimbursement.
ICD-11 vs. ICD-10 Depression Codes
While ICD-10 is currently the standard in the United States, it’s helpful to understand how depression coding will evolve with ICD-11, which is already being implemented in some countries.
Preview of ICD-11 Categories
ICD-11 reorganizes mental health disorders, including depression:
- 6A70: Single episode depressive disorder
- 6A71: Recurrent depressive disorder
- 6A72: Mixed depressive and anxiety disorder
- 6A73: Adjusted disorder with depressive mood
- 6A7Z: Depressive disorders, unspecified
Differences in Terminology
ICD-11 introduces several notable changes:
- Simplified Structure: Fewer subcategories with more focus on core features
- Dimensional Approach: Greater emphasis on symptom dimensions rather than discrete categories
- Improved Clinical Utility: Designed to be more user-friendly for clinicians
- Better Integration with Research: Aligns more closely with current scientific understanding of depression
- Cultural Sensitivity: More attention to cultural variations in depression presentation
While the United States is not expected to adopt ICD-11 in the immediate future, clinicians and coders should be aware of these upcoming changes as they represent the future direction of diagnostic coding.
Conclusion
Accurate ICD-10 coding for depression is more than just a billing necessity; it plays a crucial role in ensuring patients receive the right care and that treatment is appropriately tracked.
By using the correct codes, especially in light of recent updates for 2025, clinicians and coders can avoid common mistakes, improve documentation quality, and help facilitate smoother insurance processing.
With a clear understanding of the ICD-10 system and its nuances, healthcare professionals can make a significant impact on both patient outcomes and the broader healthcare system.
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Frequently Asked Questions (FAQs)
Is F32.9 the same as unspecified depression?
Yes, F32.9 is the code for “Major depressive disorder, single episode, unspecified.” It should be used when the clinician documents a single episode of major depression but doesn’t specify the severity or other details. However, best practice is to use the most specific code possible based on available documentation.
What’s the difference between F32 and F33 codes?
The primary difference is that F32 codes are used for single episodes of major depressive disorder, while F33 codes are used for recurrent major depressive disorder. To use an F33 code, the patient must have a history of at least one previous major depressive episode. This distinction is clinically important as recurrent depression may have different treatment implications and prognostic considerations.
What code is used for postpartum depression?
For depression that occurs during pregnancy or within four weeks after delivery (postpartum), you would typically use the regular depression codes (F32.x or F33.x) with the appropriate severity specifier. The provider should document that this is a peripartum onset episode. For postpartum depression that occurs beyond the immediate postpartum period but is still related to childbirth, F53.0 (Postpartum depression) may be used, though many clinicians continue to use the standard depression codes with documentation of the relationship to childbirth.
Can depression be coded without specifying severity?
While it’s possible to use unspecified codes like F32.9 or F33.9 when severity isn’t documented, best practice is to code to the highest level of specificity available in the documentation. If the clinical record contains information about severity (mild, moderate, severe), the corresponding specific code should be used. Unspecified codes may result in claim denials or requests for additional documentation from payers.
Are ICD-10 codes used worldwide?
ICD-10 is used worldwide for mortality reporting and many countries use it for morbidity reporting as well. However, the United States uses a modified version called ICD-10-CM (Clinical Modification) for diagnosis coding in healthcare settings. This version has more detailed codes than the standard ICD-10 used in many other countries. Some countries have already begun implementing ICD-11, which was released by WHO in 2018, but the US is expected to continue using ICD-10-CM for the foreseeable future.
