ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 F30.9

Billable / Specific HCC v28: 59 CC

Manic episode, unspecified

F30
Block
1
Synonyms
167
LCDs
8
Payer Policies
0
Linked CPTs

About ICD-10-CM F30.9

ICD-10-CM code F30.9 represents Manic episode, unspecified. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F30). The 2026 edition of ICD-10-CM F30.9 became effective on October 1, 2025.

Coding Tips for F30.9

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

HCC capture: document with MEAT each year

F30.9 is a CMS-HCC v28 risk-adjustment code (category 59). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.

Inpatient DRG impact: CC

F30.9 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under F30.9. Per CMS ICD-10-CM Tabular 2026.

  • Mania NOS

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 59
ESRD-HCC
Category 58
RxHCC (Part D)
Category 58

Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.

Inpatient DRG Impact, CC

codes Manic episode, unspecified. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for F30.9

Local Coverage Determinations (LCDs) from CMS MACs that list F30.9 as a covered diagnosis.

167 LCDs

Showing top 10 of 167 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Article ID: 56645, Effective: 2024-10-01 00:00:00, 1310 covered, 1 non-covered
CPT G0480 →
CMS LCD: Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Article ID: 56645, Effective: 2024-10-01 00:00:00, 1310 covered, 1 non-covered
CPT G0481 →
CMS LCD: Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Article ID: 56645, Effective: 2024-10-01 00:00:00, 1310 covered, 1 non-covered
CPT G0482 →
CMS LCD: Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Article ID: 56645, Effective: 2024-10-01 00:00:00, 1310 covered, 1 non-covered
CPT G0483 →
CMS LCD: Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Article ID: 56645, Effective: 2024-10-01 00:00:00, 1310 covered, 1 non-covered
CPT 80305 →
CMS LCD: Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Article ID: 56645, Effective: 2024-10-01 00:00:00, 1310 covered, 1 non-covered
CPT G0659 →
CMS LCD: Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Article ID: 56645, Effective: 2024-10-01 00:00:00, 1310 covered, 1 non-covered
CPT 80307 →
CMS LCD: Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Article ID: 56645, Effective: 2024-10-01 00:00:00, 1310 covered, 1 non-covered
CPT 80306 →
CMS LCD: Billing and Coding: Psychological and Neuropsychological Tests
Article ID: 57780, Effective: 2025-10-01 00:00:00, 1784 covered, 1 non-covered
CPT 96131 →
CMS LCD: Billing and Coding: Psychological and Neuropsychological Tests
Article ID: 57780, Effective: 2025-10-01 00:00:00, 1784 covered, 1 non-covered
CPT 96130 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing F30.9.

8 policies

1 Cigna

Neuropsychological Testing - (EN0258)
Policy ID: EN_MM_0258

5 Medicare

Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Policy ID: ART-56645
Billing and Coding: Psychiatry and Psychology Services
Policy ID: ART-56937
Billing and Coding: Outpatient Psychiatry and Psychology Services
Policy ID: ART-57065
Billing and Coding: Monitored Anesthesia Care
Policy ID: ART-57361
Billing and Coding: Psychiatry and Psychology Services
Policy ID: ART-57480

1 Aetna

Electroconvulsive Therapy
Policy ID: CPB-0445

CPT Codes Commonly Billed with F30.9

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for F30.9

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Convert F30.9 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
F30.9 29600 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 F30.9, Billing FAQ

Is ICD-10 code F30.9 billable? +

Yes, F30.9 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to F30.9? +

ICD-10 F30.9 includes: Mania NOS.

Does F30.9 affect Medicare Advantage HCC risk adjustment? +

Yes. F30.9 maps to CMS-HCC v28 category 59. Capture this diagnosis annually for accurate Medicare Advantage risk score.

Is F30.9 a CC or MCC for inpatient DRG? +

Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.

What ICD-9 codes does F30.9 map to? +

Per CMS GEMs, F30.9 maps to ICD-9 codes: 29600. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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