CODING AND LABELING THE MOOD DISORDERS
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CODING AND LABELING THE MOOD DISORDERS
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Coding and labeling the mood disorders, especially major depressive disorder and bipolar I disorder, have always been complex undertakings—and DSM-5 and ICD-10 have further complicated them. Table 3.2 lays out the possible codes for bipolar I and major depressive disorders. A footnote to this table give two examples of how to label particular presentations of these disorders.
In addition to the three bipolar types listed in Table 3.2, there is also the possibility of bipolar I, unspecified type. That’s mainly intended for the folks in the record room when we neglect to indicate the polarity of the most recent episode. We clinicians should ordinarily have little occasion to use this code. Because the episode type is unknown, no episode specifiers can apply.
Table 3.3 summarizes all the descriptors and specifiers that can apply to mood disorders, and indicates with which disorders each modifier can be used.
DSM-5 doesn’t say that the depression of bipolar II disorder can have atypical, melancholic, or psychotic features. But neither does it say that it can’t. I say that if you encounter a patient with bipolar II disorder who has any of those features, step right up and declare it. It’ll do you a world of good.
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