Name of the Condition

• Bipolar Disorder, Current Episode Mixed, Severe, Without Psychotic Features
• ICD Code: F31.63

Summary

Bipolar disorder is a mental health condition characterized by extreme mood swings, including emotional highs (mania or hypomania) and lows (depression). In a mixed episode, symptoms of mania and depression occur simultaneously. This specific condition is severe but does not include psychotic features such as hallucinations or delusions.

Causes

The exact cause of bipolar disorder is not fully understood, but it is believed to be a combination of genetics, brain structure and function, and environmental factors.

Risk Factors

• Family history of bipolar disorder or other mood disorders
• Periods of excessive stress or trauma
• Substance abuse

Symptoms

• Simultaneous symptoms of mania and depression, such as agitation, restlessness, fatigue, and hopelessness
• Extremes in energy levels and activity
• Impulsive and erratic behavior

Diagnosis

• Comprehensive psychiatric evaluation
• Medical history analysis
• Mood charting or tracking to identify patterns over time

Treatment Options

• Medications: Mood stabilizers, antipsychotics, and antidepressants to manage symptoms
• Psychotherapy: Cognitive-behavioral therapy (CBT) can help in understanding thought patterns
• Lifestyle modifications: Regular sleep, exercise, and healthy diet

Prognosis and Follow-Up

With proper treatment and ongoing management, individuals can lead productive lives. Regular follow-ups with healthcare providers are essential to adjust treatments as needed and to monitor symptom progression.

Complications

• Worsening mental health symptoms if untreated
• Increased risk of substance abuse
• Difficulties with personal relationships and employment

Lifestyle & Prevention

• Adherence to a treatment plan
• Routine sleeping and eating schedules
• Stress management techniques such as meditation

When to Seek Professional Help

• Experiencing severe mood changes that impact daily life
• Thoughts of self-harm or suicidal ideation
• Inability to manage daily tasks

Additional Resources

• National Institute of Mental Health (NIMH)
• Depression and Bipolar Support Alliance (DBSA)

Tips for Medical Coders

• Confirm documentation specifies the severity and presence or absence of psychotic features.
• Ensure coding reflects the current presentation, including if the episode is mixed or predominant in nature.
• Avoid coding errors by distinguishing between bipolar types and episode severity.