ICD Code F33.9

ICD code F33.9 is used to identify a diagnosis of major depressive disorder that is recurrent but unspecified in terms of its specific characteristics or severity. This code is applied when a patient experiences repeated episodes of depression, but the details regarding the nature of these episodes, such as whether they are mild, moderate, or severe, are not specified in the medical documentation. This code helps healthcare providers and billing professionals categorize and manage the treatment and reimbursement processes for patients with this mental health condition.

1. Recurrent Episodes: The individual must have experienced more than one episode of depression. These episodes are characterized by a distinct period of at least two weeks where there is a noticeable change in mood and functioning.

2. Depressed Mood: The individual often feels sad, empty, or hopeless. This mood is present most of the day, nearly every day, as observed by themselves or others.

3. Loss of Interest or Pleasure: There is a marked decrease in interest or pleasure in all, or almost all, activities most of the day, nearly every day.

4. Significant Weight Change: There is a noticeable weight loss when not dieting or weight gain, or a decrease or increase in appetite nearly every day.

5. Sleep Disturbances: The individual experiences insomnia or hypersomnia nearly every day.

6. Psychomotor Changes: There is observable psychomotor agitation or retardation nearly every day, which is noticeable by others and not merely subjective feelings of restlessness or being slowed down.

7. Fatigue or Loss of Energy: The individual feels fatigued or experiences a loss of energy nearly every day.

8. Feelings of Worthlessness or Guilt: There are feelings of worthlessness or excessive or inappropriate guilt nearly every day.

9. Diminished Ability to Think or Concentrate: The individual has a diminished ability to think, concentrate, or make decisions nearly every day.

10. Recurrent Thoughts of Death: There are recurrent thoughts of death, suicidal ideation without a specific plan, or a suicide attempt or specific plan for committing suicide.

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

12. Exclusion of Other Causes: The depressive episodes are not attributable to the physiological effects of a substance or another medical condition.

13. Exclusion of Other Disorders: The symptoms are not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified and unspecified schizophrenia spectrum and other psychotic disorders.

14. Absence of Manic or Hypomanic Episodes: There has never been a manic episode or a hypomanic episode, which would suggest a different diagnosis.

For the ICD code F33.9, which pertains to major depressive disorder, recurrent, unspecified, the relevant CPT codes that may be applicable for treatment include:

1. 90832 - Psychotherapy, 30 minutes with patient

2. 90834 - Psychotherapy, 45 minutes with patient

3. 90837 - Psychotherapy, 60 minutes with patient

4. 90839 - Psychotherapy for crisis, first 60 minutes

5. 90840 - Psychotherapy for crisis, each additional 30 minutes

6. 90846 - Family psychotherapy (without the patient present), 50 minutes

7. 90847 - Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes

8. 99201-99215 - Evaluation and management services, depending on the complexity and time spent

9. 96127 - Brief emotional/behavioral assessment (e.g., depression inventory)

10. G0444 - Annual depression screening, 15 minutes

These CPT codes are commonly used in the treatment and management of conditions associated with ICD code F33.9. It's important for healthcare providers to select the appropriate CPT code based on the specific services rendered and the clinical context.

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