ICD-10 Code F31.64 – Bipolar disorder, current episode mixed, severe, with psychotic features (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code F31.64 – Bipolar disorder, current episode mixed, severe, with psychotic features
What it is
Use this code for bipolar disorder when the current episode is mixed, severe, and includes psychotic features. It indicates both manic and depressive symptoms are present at the same time, with hallucinations, delusions, or similar psychosis.
Clinical signs
Clinical features vary; refer to documentation. Typical mixed episodes include elevated or irritable mood, increased energy, decreased need for sleep, plus depressive symptoms such as low mood, hopelessness, or loss of interest. Psychotic features must also be documented.
When to use this code
Use F31.64 when the provider documents bipolar disorder with a current mixed episode that is severe and psychotic. Apply it when both manic and depressive symptoms are active during the same episode, and the record supports psychosis. Check documentation if severity or psychotic features are unclear.
Do not use for
Do not use this code for bipolar disorder without psychotic features, or for a manic or depressive episode alone. If the chart does not specify a mixed episode or severe presentation, choose the more accurate documented code.
Coding tip
Confirm that “mixed,” “severe,” and “with psychotic features” are all stated in the record before assigning F31.64.