Manic episode, severe with psychotic symptoms

This code signifies a severe manic episode characterized by a distinct period of abnormally and persistently elevated, expansive, or irritable mood, accompanied by increased activity or energy. Crucially, the individual experiences psychotic features such as delusions (e.g., grandiose, persecutory) or hallucinations (e.g., auditory, visual) during this manic phase. These symptoms are severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization to prevent harm to self or others.

This code is appropriate when a patient presents with a full-blown manic episode where the severity includes psychotic symptoms. Documentation should clearly describe the manic symptoms (e.g., grandiosity, decreased need for sleep, pressured speech) alongside specific psychotic features (e.g., "patient believes they are God," "reports hearing voices commanding them"). This diagnosis requires a comprehensive psychiatric evaluation confirming the presence and severity of both manic and psychotic elements.

• Differentiate from other specified or unspecified manic episodes by ensuring documentation explicitly states the presence of psychotic features.
• Carefully review documentation to distinguish between mood-congruent and mood-incongruent psychotic features, although both fall under this code.
• Consider sequencing this code as the primary diagnosis when it is the main reason for the encounter or hospitalization.