ICD Code F33.2

ICD code F33.2 is a classification used to identify a recurrent episode of major depressive disorder that is severe in nature but does not include any psychotic features. This code is utilized by healthcare providers to document and communicate the diagnosis of patients who experience repeated episodes of significant depression, characterized by intense symptoms that impact daily functioning, yet without hallucinations or delusions.

1. Recurrent Episodes: The patient must have experienced multiple episodes of major depressive disorder. This means there should be a history of at least two separate depressive episodes.

2. Severity of Symptoms: The depressive episodes should be classified as severe. This typically involves a significant impact on daily functioning and the presence of numerous symptoms.

3. Core Symptoms: The patient must exhibit core symptoms such as persistent feelings of sadness, hopelessness, or emptiness, and a marked loss of interest or pleasure in most activities.

4. Additional Symptoms: At least four additional symptoms should be present, which may include:

• Significant weight loss or gain, or a decrease or increase in appetite.
• Insomnia or hypersomnia nearly every day.
• Psychomotor agitation or retardation observable by others.
• Fatigue or loss of energy nearly every day.
• Feelings of worthlessness or excessive or inappropriate guilt.
• Diminished ability to think or concentrate, or indecisiveness.
• Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

5. Duration: The symptoms must be present for at least two weeks and represent a change from previous functioning.

6. Exclusion of Psychotic Features: The depressive episodes should not include psychotic features such as delusions or hallucinations.

7. Impact on Functioning: The symptoms should cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

8. Exclusion of Other Causes: The symptoms should not be attributable to the physiological effects of a substance or another medical condition.

9. Differential Diagnosis: The symptoms should not be better explained by another mental disorder, such as schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified and unspecified schizophrenia spectrum and other psychotic disorders.

For the ICD code F33.2, which pertains to major depressive disorder, recurrent severe without psychotic features, the relevant CPT codes that may be applicable for treatment include:

1. 90837 - Psychotherapy, 60 minutes with patient.
2. 90834 - Psychotherapy, 45 minutes with patient.
3. 90832 - Psychotherapy, 30 minutes with patient.
4. 90847 - Family psychotherapy (conjoint psychotherapy) with patient present, 50 minutes.
5. 99213 - Established patient office or other outpatient visit, typically 15 minutes.
6. 99214 - Established patient office or other outpatient visit, typically 25 minutes.
7. 99215 - Established patient office or other outpatient visit, typically 40 minutes.
8. 96127 - Brief emotional/behavioral assessment (e.g., depression inventory) with scoring and documentation, per standardized instrument.
9. 90839 - Psychotherapy for crisis; first 60 minutes.
10. 90840 - Psychotherapy for crisis; each additional 30 minutes (List separately in addition to code for primary service).

These CPT codes are commonly used for billing purposes when treating patients with this specific diagnosis, allowing healthcare providers to accurately document and receive reimbursement for the services provided. Always ensure that the selected CPT codes align with the specific services rendered and the patient's treatment plan.

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