ICD-10 F32.1
Billable / Specific HCC v28: 59 CCMajor depressive disorder, single episode, moderate
About ICD-10-CM F32.1
ICD-10-CM code F32.1 represents Major depressive disorder, single episode, moderate. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F32). The 2026 edition of ICD-10-CM F32.1 became effective on October 1, 2025.
Coding Tips for F32.1
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
F32.1 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.
F32.1 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.
Medicare Advantage HCC Impact
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 Major depressive disorder, single episode, moderate. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for F32.1
Local Coverage Determinations (LCDs) from CMS MACs that list F32.1 as a covered diagnosis.
Showing top 10 of 615 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing F32.1.
5 Medicare
CPT Codes Commonly Billed with F32.1
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 99490 Chronic Care Management — 2+ chronic conditions required Internal Medicine
- 99204 New patient office visit — multiple chronic conditions: HTN, T2DM, hyperlipidemia, asthma, anxiety, depression, obesity, IBS, COPD, thyroid, anemia, CAD, sleep apnea, psoriasis, RA Primary Care
- 99214 Established patient — moderate complexity: uncontrolled HTN, diabetes with complications, multiple chronic conditions, COPD, AFib, CKD, sleep apnea, chronic pain, depression Primary Care
- 90834 Psychotherapy 45 min — GAD, anxiety, MDD, recurrent depression, PTSD, adjustment disorder, BPD, OCD, bipolar, ADHD, autism, anorexia, bulimia Psychiatry
- 90837 Psychotherapy 60 min — same as 90834 plus substance use disorders, severe depression Psychiatry
- 90832 Psychotherapy 30 min — mild-moderate anxiety, depression, adjustment disorder, emotional distress, relationship problems Psychiatry
- 90833 Psychotherapy 30 min add-on to E/M — anxiety, depression, PTSD, bipolar, OCD, BPD, ADHD Psychiatry
- 90836 Psychotherapy 45 min add-on to E/M — anxiety, depression, PTSD, bipolar, OCD, BPD, substance use Psychiatry
- 0034U CMS LCD: Billing and Coding: MolDX: Pharmacogenomics Testing CMS LCD
- 0074U CMS LCD: Billing and Coding: MolDX: Pharmacogenomics Testing CMS LCD
Convert F32.1 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| F32.1 | 29622 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To F32.1
Other codes in section F30-F39 (Mood [affective] disorders).
ICD-10 F32.1, Billing FAQ
Is ICD-10 code F32.1 billable? +
Yes, F32.1 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does F32.1 affect Medicare Advantage HCC risk adjustment? +
Yes. F32.1 maps to CMS-HCC v28 category 59. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is F32.1 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 CPT codes are commonly billed with F32.1? +
Procedures frequently paired with F32.1 include: 99490, 99204, 99214, 90834, 90837.
What ICD-9 codes does F32.1 map to? +
Per CMS GEMs, F32.1 maps to ICD-9 codes: 29622. 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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