F32.3 Major depressive disorder, single episode, severe with psychotic features

Billable ICD-10-CM code, FY2026. Acts as a Complication or Comorbidity (CC) as a secondary diagnosis.

Applicable to

• Single episode of major depression with mood-congruent psychotic symptoms
• Single episode of major depression with mood-incongruent psychotic symptoms
• Single episode of major depression with psychotic symptoms
• Single episode of psychogenic depressive psychosis
• Single episode of psychotic depression
• Single episode of reactive depressive psychosis

Applies from F32 Depressive episode

Includes

• single episode of agitated depression
• single episode of depressive reaction
• single episode of major depression
• single episode of psychogenic depression
• single episode of reactive depression
• single episode of vital depression

Excludes1 (never code together)

• bipolar disorder (F31.-)
• manic episode (F30.-)
• recurrent depressive disorder (F33.-)

Excludes2 (not included here)

• adjustment disorder (F43.2)

Risk adjustment (HCC)

• CMS-HCC V28: HCC 152 — Psychosis, Except Schizophrenia
• CMS-HCC V22: HCC 58 — Major Depressive, Bipolar, and Paranoid Disorders
• RxHCC V08: HCC 132 — Depression
• ESRD V24: HCC 59

MS-DRG index

Defines the logic of DRG(s) 885 in MDC 19.

Approximate ICD-9-CM (GEMs)

• 296.24 Major depressive affective disorder, single episode, severe, specified as with psychotic behavior (approximate)
• 298.0 Depressive type psychosis (approximate)

Code annotations containing back-references to F32.3

Back-references to F32.3

• Type 1 Excludes: F20 Schizophrenia ("mood [affective] disorders with psychotic symptoms (F30.2, F31.2, F31.5, F31.64, F32.3, F33.3)")
• Type 1 Excludes: F22 Delusional disorders ("mood [affective] disorders with psychotic symptoms (F30.2, F31.2, F31.5, F31.64, F32.3, F33.3)")
• Type 2 Excludes: F23 Brief psychotic disorder ("mood [affective] disorders with psychotic symptoms (F30.2, F31.2, F31.5, F31.64, F32.3, F33.3)")
• Type 1 Excludes: F25 Schizoaffective disorders ("mood [affective] disorders with psychotic symptoms (F30.2, F31.2, F31.5, F31.64, F32.3, F33.3)")
• Type 1 Excludes: F53 Mental and behavioral disorders associated with the puerperium, not elsewhere classified ("mood disorders with psychotic features (F30.2, F31.2, F31.5, F31.64, F32.3, F33.3)")
• Type 1 Excludes: R44 Other symptoms and signs involving general sensations and perceptions ("hallucinations in mood disorders with psychotic symptoms (F30.2, F31.5, F32.3, F33.3)")

Back-references to F32

• Type 2 Excludes: F06.3 Mood disorder due to known physiological condition ("mood disorders, not due to known physiological condition or unspecified (F30-F39)")
• Type 1 Excludes: F30 Manic episode ("major depressive disorder, single episode (F32.-)")
• Type 1 Excludes: F31 Bipolar disorder ("major depressive disorder, single episode (F32.-)")
• Type 2 Excludes: F42 Obsessive-compulsive disorder ("obsessive-compulsive symptoms occurring in depression (F32.-, F33.-)")
• Type 2 Excludes: F44.2 Dissociative stupor ("depressive stupor (F32, F33)")
• Type 2 Excludes: F63.2 Kleptomania ("depressive disorder with stealing (F31.-, F32.-, F33.-)")
• Type 2 Excludes: F90 Attention-deficit hyperactivity disorders ("mood [affective] disorders (F30-F39)")
• Type 2 Excludes: F91 Conduct disorders ("mood [affective] disorders (F30-F39)")
• Type 2 Excludes: F93.0 Separation anxiety disorder of childhood ("mood [affective] disorders (F30-F39)")
• Type 1 Excludes: R40.1 Stupor ("depressive stupor (F31.-, F32.-, F33.-)")
• Type 2 Excludes: R53.83 Other fatigue ("exhaustion and fatigue due to depressive episode (F32.-)")

Diagnosis Index entries for F32.3

• Depression (acute) (mental) › major › with psychotic symptoms
• Depression (acute) (mental) › psychotic (single episode)
• Depression (acute) (mental) › reactive (psychogenic) (single episode) › psychotic (single episode)
• Disorder (of) › depressive › major › with psychotic symptoms
• Disorder (of) › depressive › major › single episode › severe (without psychotic symptoms) › with psychotic symptoms
• Episode › depressive › major › severe (without psychotic symptoms) › with psychotic symptoms
• Melancholia › reactive (emotional stress or trauma)
• Psychosis, psychotic › psychogenic (paranoid) › depressive
• Psychosis, psychotic › reactive (brief) (transient) (emotional stress) (psychological trauma) › depressive
• Reaction › depressive (single episode) › psychotic

Nearby codes

• F32 Depressive episode
• F32.0 Major depressive disorder, single episode, mild
• F32.1 Major depressive disorder, single episode, moderate
• F32.2 Major depressive disorder, single episode, severe without psychotic features
• F32.3 Major depressive disorder, single episode, severe with psychotic features (this code)
• F32.4 Major depressive disorder, single episode, in partial remission
• F32.5 Major depressive disorder, single episode, in full remission
• F32.8 Other depressive episodes
• F32.81 Premenstrual dysphoric disorder
• F32.89 Other specified depressive episodes