ICD-10 F33.3
Billable / Specific HCC v28: 59 CCMajor depressive disorder, recurrent, severe with psychotic symptoms
About ICD-10-CM F33.3
ICD-10-CM code F33.3 represents Major depressive disorder, recurrent, severe with psychotic symptoms. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F33). The 2026 edition of ICD-10-CM F33.3 became effective on October 1, 2025.
Coding Tips for F33.3
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
F33.3 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.
F33.3 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 F33.3. Per CMS ICD-10-CM Tabular 2026.
- Endogenous depression with psychotic symptoms
- Major depressive disorder, recurrent, with psychotic features
- Recurrent severe episodes of major depression with mood-congruent psychotic symptoms
- Recurrent severe episodes of major depression with mood-incongruent psychotic symptoms
- Recurrent severe episodes of major depression with psychotic symptoms
- Recurrent severe episodes of psychogenic depressive psychosis
- Recurrent severe episodes of psychotic depression
- Recurrent severe episodes of reactive depressive psychosis
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, recurrent, severe with psychotic symptoms. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for F33.3
Local Coverage Determinations (LCDs) from CMS MACs that list F33.3 as a covered diagnosis.
Showing top 10 of 626 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing F33.3.
5 Medicare
CPT Codes Commonly Billed with F33.3
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 0034U CMS LCD: Billing and Coding: MolDX: Pharmacogenomics Testing CMS LCD
- 0074U CMS LCD: Billing and Coding: MolDX: Pharmacogenomics Testing CMS LCD
- 81232 CMS LCD: Billing and Coding: MolDX: Pharmacogenomics Testing CMS LCD
- 81401 CMS LCD: Billing and Coding: MolDX: Pharmacogenomics Testing CMS LCD
- 0030U CMS LCD: Billing and Coding: MolDX: Pharmacogenomics Testing CMS LCD
- 81350 CMS LCD: Billing and Coding: MolDX: Pharmacogenomics Testing CMS LCD
- 0071U CMS LCD: Billing and Coding: MolDX: Pharmacogenomics Testing CMS LCD
- 81406 CMS LCD: Billing and Coding: MolDX: Pharmacogenomics Testing CMS LCD
- 0076U CMS LCD: Billing and Coding: MolDX: Pharmacogenomics Testing CMS LCD
- 81328 CMS LCD: Billing and Coding: MolDX: Pharmacogenomics Testing CMS LCD
Convert F33.3 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 |
|---|---|---|
| F33.3 | 29634 | 10000 |
| F33.3 | 2980 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To F33.3
Other codes in section F30-F39 (Mood [affective] disorders).
ICD-10 F33.3, Billing FAQ
Is ICD-10 code F33.3 billable? +
Yes, F33.3 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 F33.3? +
ICD-10 F33.3 includes: Endogenous depression with psychotic symptoms; Major depressive disorder, recurrent, with psychotic features; Recurrent severe episodes of major depression with mood-congruent psychotic symptoms, and 5 more clinical synonyms.
Does F33.3 affect Medicare Advantage HCC risk adjustment? +
Yes. F33.3 maps to CMS-HCC v28 category 59. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is F33.3 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 F33.3? +
Procedures frequently paired with F33.3 include: 0034U, 0074U, 81232, 81401, 0030U.
What ICD-9 codes does F33.3 map to? +
Per CMS GEMs, F33.3 maps to ICD-9 codes: 29634, 2980. 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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