ICD-10 Code for Major Depressive Disorder
The ICD-10 code for Major Depressive Disorder (MDD) is F32 for a single depressive episode or F33 for recurrent depressive disorder, with additional digits required to specify severity and presence of psychotic features.
Core Diagnostic Codes
The ICD-10 classification system categorizes MDD under the F3 category as "mood (affective) disorders," with specific codes based on episode pattern and severity 1:
- F32 - Depressive episode: Used for a single episode of depression 1
- F33 - Recurrent depressive disorder: Used when multiple depressive episodes have occurred 1
Required Specificity with Additional Digits
The base codes F32 and F33 require additional digits to create a complete, billable diagnosis code:
- Fourth digit specifies severity: Mild, moderate, or severe 1
- Fifth digit may indicate presence of psychotic symptoms: Depression with psychotic symptoms carries different prognostic implications, with greater risk of relapse leading to readmission compared to depression without psychotic features 2
Clinical Context for Code Selection
When selecting the appropriate ICD-10 code, document the following:
- Episode pattern: Determine whether this is the patient's first depressive episode (F32) or if there is a history of previous episodes (F33) 1
- Severity assessment: The diagnosis requires at least five out of ten depressive symptoms, with one being either depressed mood or diminished interest/pleasure 3, 4
- Psychotic features: The presence or absence of psychotic symptoms has prognostic significance and should be coded specifically, as patients with psychotic depression have higher relapse rates 2
Important Coding Considerations
- The ICD-10 melancholic subtype specification does not have long-term predictive value for relapse or suicide risk, though it remains a coding option 2
- Bereavement context should be considered: if depressive symptoms are consistent with normative grief responses within the patient's cultural context, the diagnostic threshold is raised 4
- For chronic depression lasting over 2 years, consider dysthymia (F34.1) as an alternative or additional diagnosis 1, 5
Transition to ICD-11
The ICD-11 system (effective 2022 for WHO reporting) maintains similar diagnostic thresholds but introduces dimensional symptom severity rating across six domains, though the fundamental categorical codes remain consistent with ICD-10 structure 6, 4.