F33.3 Major depressive disorder, recurrent, severe with psychotic symptoms

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

Applicable to

• Endogenous depression with psychotic symptoms
• Major depressive disorder, recurrent, with psychotic features
• Recurrent severe episodes of major depression with mood-congruent psychotic symptoms
• Recurrent severe episodes of major depression with mood-incongruent psychotic symptoms
• Recurrent severe episodes of major depression with psychotic symptoms
• Recurrent severe episodes of psychogenic depressive psychosis
• Recurrent severe episodes of psychotic depression
• Recurrent severe episodes of reactive depressive psychosis

Applies from F33 Major depressive disorder, recurrent

Includes

• recurrent episodes of depressive reaction
• recurrent episodes of endogenous depression
• recurrent episodes of major depression
• recurrent episodes of psychogenic depression
• recurrent episodes of reactive depression
• recurrent episodes of seasonal affective disorder
• recurrent episodes of seasonal depressive disorder
• recurrent episodes of vital depression

Excludes1 (never code together)

• bipolar disorder (F31.-)
• manic episode (F30.-)

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)

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

Code annotations containing back-references to F33.3

Back-references to F33.3

• 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 F33

• 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, recurrent (F33.-)")
• Type 1 Excludes: F31 Bipolar disorder ("major depressive disorder, recurrent (F33.-)")
• Type 1 Excludes: F32 Depressive episode ("recurrent depressive disorder (F33.-)")
• 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 1 Excludes: R53.8 Other malaise and fatigue ("exhaustion and fatigue due to recurrent depressive episode (F33-)")

Diagnosis Index entries for F33.3

• Depression (acute) (mental) › endogenous (without psychotic symptoms) › with psychotic symptoms
• Depression (acute) (mental) › psychotic (single episode) › recurrent
• Depression (acute) (mental) › vital (recurrent) (without psychotic symptoms) › with psychotic symptoms
• Disorder (of) › depressive › major › recurrent › with psychotic features
• Disorder (of) › depressive › recurrent › current episode › severe (without psychotic symptoms) › with psychotic symptoms
• Psychosis, psychotic › reactive (brief) (transient) (emotional stress) (psychological trauma) › depressive › recurrent

Nearby codes

• F33 Major depressive disorder, recurrent
• F33.0 Major depressive disorder, recurrent, mild
• F33.1 Major depressive disorder, recurrent, moderate
• F33.2 Major depressive disorder, recurrent severe without psychotic features
• F33.3 Major depressive disorder, recurrent, severe with psychotic symptoms (this code)
• F33.4 Major depressive disorder, recurrent, in remission
• F33.40 Major depressive disorder, recurrent, in remission, unspecified
• F33.41 Major depressive disorder, recurrent, in partial remission
• F33.42 Major depressive disorder, recurrent, in full remission
• F33.8 Other recurrent depressive disorders