The Essential Guide to F31.60: What Medical Coders Need to Know in 2025

The F31.60 diagnosis code applies to approximately 2.8% of the U.S. population. This represents over 10 million Americans who live with bipolar disorder. A medical coder's accuracy with this code affects both patient care and financial results.

The F31.60 code in the ICD-10 system documents bipolar disorder with a current episode mixed, unspecified. This diagnosis code holds a average risk adjustment factor (RAF) score of 0.299. The difference between the three main types of bipolar disorder—Bipolar I, Bipolar II, and Cyclothymia—plays a key role in proper documentation. The DSM-5's updated diagnostic codes make it vital to stay current with the latest guidelines for accurate coding.

This piece will help you become skilled at F31.60 coding in 2025. You'll learn everything from documentation requirements to recent updates that shape your daily coding work.

What is ICD F31.60 and When is it Used?

The ICD code F31.60 falls under mental and behavioral disorders in the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM). Medical professionals need this code to document cases accurately and receive proper reimbursement for mental health treatments.

Definition of F31.60 in ICD-10

F31.60 stands for "Bipolar disorder, current episode mixed, unspecified." This billable code describes patients who show symptoms of both manic and major depressive episodes at the same time. The severity level isn't specified as mild, moderate, or severe. You'll find F31.60 as part of the broader F31 family of codes that cover bipolar disorders.

The F31 classification has:

• Bipolar I disorder

• Bipolar type I disorder

• Manic-depressive illness

• Manic-depressive psychosis

• Manic-depressive reaction

• Seasonal bipolar disorder

The code doesn't include bipolar disorder with a single manic episode (F30.-), major depressive disorder, single episode (F32.-), major depressive disorder, recurrent (F33.-), and cyclothymia (F34.0).

Clinical scenarios that match F31.60

Medical professionals use F31.60 when patients show both manic symptoms (increased energy, grandiosity, reduced need for sleep) and major depressive features (persistent sadness, low energy, feelings of worthlessness). They apply this code when documentation doesn't specify if these mixed symptoms are mild, moderate, or severe.

A patient might show racing thoughts and excessive energy while feeling hopeless. This matches the code if severity isn't documented. AHA Coding Clinic (First Quarter, 2020) states that doctors should only assign the bipolar code when records show both bipolar disorder and major depressive disorder.

Why specificity matters in coding

Specific coding directly shapes healthcare delivery, payments, reimbursements, and disease surveillance. F31.60 works as a valid billable code, but its "unspecified" severity should be your last option when detailed information isn't available.

The Centers for Medicare and Medicaid Services (CMS) guidelines allow reporting an unspecified code when there's not enough clinical information about a health condition. Lack of specificity can lead to:

• Higher audit risk from insufficient documentation

• Problems with reimbursement and actual healthcare costs

• Poor treatment planning and patient care outcomes

Specific codes benefit patients, providers, and payers by ensuring accurate records and proper resource allocation.

Breaking Down the F31.60 Diagnosis Code

The F31.60 diagnosis code uses a structured system that captures specific clinical details about bipolar disorders. Medical coders need to understand this code's elements to assign accurate diagnoses.

Code structure and classification

The F31.60 diagnosis code sits within the Mental and Behavioral Disorders category (F01-F99) of ICD-10-CM. The code breaks down into these components:

• F: Mental, Behavioral and Neurodevelopmental disorders chapter

• 31: Bipolar disorder category

• .6: Current episode mixed

• 0: Unspecified severity

Medical professionals can bill this code since October 1, 2024 in the 2025 ICD-10-CM edition. F31.60 works for reimbursement because it has the right level of detail, unlike its parent codes F31 or F31.6 [1].

Severity levels and specifiers

The F31.6 family codes distinguish different severity levels:

• F31.60: Unspecified severity

• F31.61: Mild

• F31.62: Moderate

• F31.63: Severe, without psychotic features

• F31.64: Severe, with psychotic features

These specifiers give vital clinical information about the patient's condition. Healthcare providers should document enough detail to pick the most specific code rather than using the unspecified option.

How F31.60 fits into the F31 family

F31.60 represents one branch in the detailed F31 bipolar disorder family tree. The broader F31 category has codes for:

• Current episode hypomanic (F31.0)

• Current episode manic (F31.1-F31.2)

• Current episode depressed (F31.3-F31.5)

• Current episode mixed (F31.6, including our F31.60)

• Currently in remission (F31.7)

• Other bipolar disorders (F31.8)

• Bipolar disorder, unspecified (F31.9)

The F31 category has significant exclusion notes. Bipolar disorder with a single manic episode (F30.-), major depressive disorder, single episode (F32.-), and major depressive disorder, recurrent (F33.-) should not appear with F31 codes [2].

Best Practices for Accurate Documentation

Accurate F31.60 coding depends on precise documentation that affects reimbursement and patient care. Medical records should paint a complete clinical picture of bipolar disorder with mixed episodes.

SOAP note essentials for F31.60

The SOAP format for F31.60 documentation requires these key elements:

• Subjective: Record the patient's self-reported symptoms of both mania and depression, onset duration, and how they affect daily functioning

• Objective: Record observable behaviors during examination, mental status findings, and relevant vital signs

• Assessment: State "Bipolar disorder, current episode mixed, unspecified" with clinical reasoning

• Plan: Detail treatment approach, medications, and follow-up timeline

Your documentation should state the complete diagnosis rather than using abbreviations or shorthand.

Linking symptoms to diagnosis

Documentation must show both manic and depressive symptoms occurring at the same time to support an F31.60 code. Your notes should connect symptoms to the diagnosis clearly. To cite an instance, see how a patient's racing thoughts and excessive energy (manic symptoms) coexist with persistent sadness and feelings of worthlessness (depressive symptoms).

Referencing DSM-5 criteria in notes

DSM-5 diagnostic criteria make your F31.60 documentation stronger. The DSM-5 lists specific criteria for bipolar disorders, including symptom thresholds and duration requirements. Your notes become more credible when they reference these criteria.

Avoiding vague or incomplete entries

Vague documentation creates audit risks and potential reimbursement problems. Watch out for these common documentation mistakes:

• Using non-specific terms like "mood disorder" without proper classification

• Not documenting the current episode type (mixed vs. manic or depressed)

• Leaving out severity indicators when known

• Recording conflicting diagnoses (bipolar disorder with separate major depression)

F31.60 represents "unspecified severity" and should be used only when detailed information isn't available. Medical coders should ask providers when documentation lacks enough specificity for accurate coding.

Tips for Coders Working with F31.60 in 2025

Becoming skilled at bipolar disorder coding requires you to stay current with the latest guidelines and best practices. These practical tips will help you work with f31.60 in 2025 and boost your coding accuracy and efficiency.

Updates in ICD-10 for 2025

The f31.60 diagnosis code has stayed stable since its introduction in 2016. No changes have occurred through the 2025 edition that became effective October 1, 2024 [3]. This stability helps coders maintain consistent documentation practices while focusing on specificity. F31.60 serves as a billable/specific ICD-10-CM code appropriate for reimbursement purposes [1].

Common payer requirements

Most payers expect:

• Complete documentation supporting both manic and depressive symptoms occurring simultaneously

• Proper application of Excludes1 notes (never code bipolar with single manic episode or major depressive disorder)

• Correct DRG assignment—f31.60 typically groups within MS-DRG v42.0: 885 Psychoses [1]

How to handle comorbidities

Documentation might show both bipolar disorder and major depressive disorder. We coded only the bipolar disorder in these cases. AHA Coding Clinic (First Quarter, 2020) states: "When documentation states bipolar disorder and mild major depressive disorder, recurrent, only assign F31.9" [4]. Patients with complex presentations may need evaluation across several appointments before reaching full diagnostic clarity [5].

Using EHR tools to flag F31.60 cases

Your EHR system should flag potential f31.60 cases when documentation mentions mixed bipolar symptoms. Don't rely too heavily on automation. Review clinical notes carefully to ensure the code matches the documented condition. Electronic systems can help identify exclusions and required documentation elements.

Training resources for new coders

New coders should focus on:

• Understanding bipolar disorder's clinical presentation

• Recognizing the differences between various mood disorders

• Becoming skilled at the exclusion notes associated with f31.60

• Following chapter-specific coding guidelines to improve understanding and usage [6]

Time spent on specialized mental health coding education leads to better accuracy and efficiency.

Conclusion

Your understanding of F31.60 coding ended up determining both patient care quality and financial outcomes for healthcare facilities. This specific code represents bipolar disorder with current mixed episodes of unspecified severity—a condition that affects over 10 million Americans. The code's structure tells a story: F for mental disorders, 31 for bipolar category, .6 for mixed episode, and 0 for unspecified severity.

Clear documentation is the life-blood of proper F31.60 coding. Your SOAP notes must clearly show both manic and depressive symptoms occurring at the same time. Vague terminology should be avoided. The code has been valid and billable since 2016, but you should use it only when severity cannot be determined from available clinical information.

Of course, becoming skilled at exclusion notes associated with bipolar disorder coding prevents common errors, especially when you have patients with complex symptom patterns. The code's stability through the 2025 ICD-10 update gives you a solid foundation for consistent documentation. Payer expectations stay stringent—they need complete evidence of both symptom categories and proper application of exclusion guidelines.

Your role as a medical coder directly impacts patient care quality. Accurate F31.60 coding will give appropriate treatment planning, resource allocation, and reimbursement rates. Precise coding for this diagnosis helps create a healthcare system that better serves those 2.8% of Americans who face the challenges of bipolar disorder with mixed episodes.

FAQs

What does the ICD-10 code F31.60 represent?

F31.60 is the code for bipolar disorder with a current mixed episode of unspecified severity. It indicates that the patient is experiencing both manic and depressive symptoms simultaneously.

How should medical coders document F31.60 in SOAP notes?

When documenting F31.60, include the patient's self-reported manic and depressive symptoms, observable behaviors, a clear statement of the diagnosis, and the treatment plan. Ensure that symptoms are explicitly linked to the diagnosis.

Can F31.60 be used with other mood disorder codes?

No, F31.60 should not be used alongside codes for single manic episodes or major depressive disorder. When both bipolar disorder and major depressive disorder are documented, only the bipolar disorder code should be assigned.

What are the severity levels within the F31.6 family of codes?

The F31.6 family includes codes for unspecified severity (F31.60), mild (F31.61), moderate (F31.62), severe without psychotic features (F31.63), and severe with psychotic features (F31.64).

How often is the F31.60 code updated?

The F31.60 code has remained stable since its introduction in 2016, with no changes through the 2025 edition of ICD-10. This stability allows for consistent documentation practices while focusing on specificity in coding.

References

[1] - https://www.icd10data.com/ICD10CM/Codes/F01-F99/F30-F39/F31-/F31.60
[2] - https://www.aapc.com/codes/icd-10-codes/F31.6?srsltid=AfmBOorKbNifhkf_dJhxBfqKDlfSOyvQ9AkdkIWbvfYm8IeZSom5xUsm
[3] - https://medgenius.com/icd-10-cm/codes/F31.60
[4] - https://www.aapc.com/codes/icd-10-codes/F31.60?srsltid=AfmBOopxdg6t13WCIFndFeJxm2czrbHgGOkhnyUsRUt2AMwAIlomFcSj
[5] - https://www.psychiatrictimes.com/view/diagnosis-in-bipolar-disorder-dealing-with-comorbidity
[6] - https://www.aapc.com/codes/icd-10-codes/F31.60?srsltid=AfmBOorFRTB_IcZhVMDk63n9xoXi1FLzzAMoVhcCsE4p-e7js6aq5Af9