F32.2 ICD-10-CM Code: Major depressive disorder, single episode, severe without psychotic features

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for F32.2 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on F32.2 itself; “inherited from” names the category or block whose note applies here.

Coder workflow for F32.2

MedCoder structured workflow — derived from this code’s own official record

Before you code F32.2

1. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with F32.2. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

   See the official tabular notes

Choose the right path

1. Does the documentation support a condition named in F32.2’s Excludes1 note?
   Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
   No → Continue.

   ReviewF31, F30, F33

Consider F32.2. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement

Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).

Severity

Mild, moderate or severe as the provider states it; severity is not inferred from the clinical picture.

Remission status

Remission is coded only when the provider documents it.

The associated condition or complication

Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).

Official instructions as workflow

• Excludes1 — check before selecting F32.2(3 notes)

  Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with F32.2: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

  CompareF31, F30, F33

  See the official tabular notes · Guidelines I.A.12.a

• Excludes2 — not part of F32.2(1 note)

  Coding workflow: The conditions named in this note are not included in F32.2. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

  CompareF43.2

  See the official tabular notes · Guidelines I.A.12.b

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Indexed Clinical Terms (6)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

• Depression (acute) (mental), agitated (single episode)
• Depression (acute) (mental), severe, single episode
• Depression (acute) (mental), vital (recurrent) (without psychotic symptoms), single episode
• Disorder (of), depressive, major, single episode, severe (without psychotic symptoms)
• Episode, depressive, major, severe (without psychotic symptoms)
• Menopause, menopausal (asymptomatic) (state), depression (single episode), agitated (single episode)

Don’t confuse F32.2 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of F32.2 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

• F31— Excludes1 conflict (Excludes1 — generally not reported together)

  Not coded here — the tabular list excludes this pair for the same encounter.

  Not reported together with this code, except where the two conditions are documented as unrelated.

  What moves you there: Documentation of bipolar disorder moves the case to F31; the two are not reported together unless documented as unrelated.

  Full comparison: F32.2 vs F31 →

• F30— Excludes1 conflict (Excludes1 — generally not reported together)

  Not coded here — the tabular list excludes this pair for the same encounter.

  Not reported together with this code, except where the two conditions are documented as unrelated.

  What moves you there: Documentation of manic episode moves the case to F30; the two are not reported together unless documented as unrelated.

  Full comparison: F32.2 vs F30 →

• F33— Excludes1 conflict (Excludes1 — generally not reported together)

  Not coded here — the tabular list excludes this pair for the same encounter.

  Not reported together with this code, except where the two conditions are documented as unrelated.

  What moves you there: Documentation of recurrent depressive disorder moves the case to F33; the two are not reported together unless documented as unrelated.

  Full comparison: F32.2 vs F33 →

• F32.9— Specificity relationship (Review)

  Overlapping diagnoses in the same category.

  Overlapping codes in the same category — the documentation decides which is the more specific fit.

  What moves you there: A record that documents no more than “Major depressive disorder, single episode, unspecified” takes F32.9; specificity in the record moves it back here.

  Full comparison: F32.2 vs F32.9 →

• F43.2— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of adjustment disorder adds F43.2; it is not part of this code and both may be reported when both are documented.

  Full comparison: F32.2 vs F43.2 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Verify Before Coding

• CC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name F32.2 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 3 Excludes1 notes across 2 chapters: F30 — Manic episode (via F32.-), F31 — Bipolar disorder (via F32.-), R40.1 — Stupor (via F32.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 7 Excludes2 notes across 2 chapters: F06.3 — Mood disorder due to known physiological condition (via F32.-), F42 — Obsessive-compulsive disorder (via F32.-), F63.2 — Kleptomania (via F32.-), F90 — Attention-deficit hyperactivity disorders (via F32.-), F91 — Conduct disorders (via F32.-), F93.0 — Separation anxiety disorder of childhood (via F32.-), R53.83 — Other fatigue (via F32.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 12 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 1 MS-DRG: DRG 885 (MDC 19).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):MBD002 — Depressive disorders (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical process (MS-DRG)

Acts as CC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.

F32.0 — Major depressive disorder, single episode, mild, F32.1 — Major depressive disorder, single episode, moderate, F32.3 — Major depressive disorder, single episode, severe with psychotic features, F33.0 — Major depressive disorder, recurrent, mild, F33.1 — Major depressive disorder, recurrent, moderate, F33.2 — Major depressive disorder, recurrent severe without psychotic features, F33.3 — Major depressive disorder, recurrent, severe with psychotic symptoms, F33.40 — Major depressive disorder, recurrent, in remission, unspecified, F33.9 — Major depressive disorder, recurrent, unspecified, F43.81 — Prolonged grief disorder, F43.89 — Other reactions to severe stress

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Major Depression, Moderate or Severe, without Psychosis) for risk-adjusted payment.

F32.1 — Major depressive disorder, single episode, moderate, F33.1 — Major depressive disorder, recurrent, moderate, F33.2 — Major depressive disorder, recurrent severe without psychotic features, R45.88 — Nonsuicidal self-harm, T14.91XA — Suicide attempt, initial encounter, T36.0X2A — Poisoning by penicillins, intentional self-harm, initial encounter, T36.1X2A — Poisoning by cephalosporins and other beta-lactam antibiotics, intentional self-harm, initial encounter, T36.2X2A — Poisoning by chloramphenicol group, intentional self-harm, initial encounter, T36.3X2A — Poisoning by macrolides, intentional self-harm, initial encounter, T36.4X2A — Poisoning by tetracyclines, intentional self-harm, initial encounter, T36.5X2A — Poisoning by aminoglycosides, intentional self-harm, initial encounter, T36.6X2A — Poisoning by rifampicins, intentional self-harm, initial encounter, T36.7X2A — Poisoning by antifungal antibiotics, systemically used, intentional self-harm, initial encounter, T36.8X2A — Poisoning by other systemic antibiotics, intentional self-harm, initial encounter, T36.92XA — Poisoning by unspecified systemic antibiotic, intentional self-harm, initial encounter, T36.AX2A — Poisoning by fluoroquinolone antibiotics, intentional self-harm, initial encounter, T37.0X2A — Poisoning by sulfonamides, intentional self-harm, initial encounter, T37.1X2A — Poisoning by antimycobacterial drugs, intentional self-harm, initial encounter, T37.2X2A — Poisoning by antimalarials and drugs acting on other blood protozoa, intentional self-harm, initial encounter, T37.3X2A — Poisoning by other antiprotozoal drugs, intentional self-harm, initial encounter, +350 more

Related risk categories

These categories interact through CMS's HCC hierarchy — one can suppress the other's risk-adjustment weight when both are present on a claim.

Schizophrenia, Psychosis, Except Schizophrenia, Personality Disorders; Anorexia/Bulimia Nervosa, Bipolar Disorders without Psychosis

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Depressive disorders).

F06.31 — Mood disorder due to known physiological condition with depressive features, F06.32 — Mood disorder due to known physiological condition with major depressive-like episode, F06.34 — Mood disorder due to known physiological condition with mixed features, F32.0 — Major depressive disorder, single episode, mild, F32.1 — Major depressive disorder, single episode, moderate, F32.3 — Major depressive disorder, single episode, severe with psychotic features, F32.4 — Major depressive disorder, single episode, in partial remission, F32.8 — Other depressive episodes, F32.81 — Premenstrual dysphoric disorder, F32.89 — Other specified depressive episodes, F32.9 — Major depressive disorder, single episode, unspecified, F32.A — Depression, unspecified, F33.0 — Major depressive disorder, recurrent, mild, F33.1 — Major depressive disorder, recurrent, moderate, F33.2 — Major depressive disorder, recurrent severe without psychotic features, F33.3 — Major depressive disorder, recurrent, severe with psychotic symptoms, F33.41 — Major depressive disorder, recurrent, in partial remission, F33.8 — Other recurrent depressive disorders, F33.9 — Major depressive disorder, recurrent, unspecified, F34.1 — Dysthymic disorder, +2 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Depression”, “Episode”, “Menopause, menopausal”; these codes share that main term but sit in a different category of the Tabular List.

F30.10 — Manic episode without psychotic symptoms, unspecified (manic, without psychotic symptoms), F30.11 — Manic episode without psychotic symptoms, mild (manic, without psychotic symptoms, mild), F30.12 — Manic episode without psychotic symptoms, moderate (manic, without psychotic symptoms, moderate), F30.13 — Manic episode, severe, without psychotic symptoms (manic, without psychotic symptoms, severe), F30.2 — Manic episode, severe with psychotic symptoms (manic, with, psychotic symptoms), F30.3 — Manic episode in partial remission (manic, with, remission, partial), F30.4 — Manic episode in full remission (manic, with, remission), F30.8 — Other manic episodes (hypomanic), F30.9 — Manic episode, unspecified (manic), F31.89 — Other bipolar disorder (manic, recurrent), F33.2 — Major depressive disorder, recurrent severe without psychotic features (vital), F33.3 — Major depressive disorder, recurrent, severe with psychotic symptoms (psychotic, recurrent), F33.8 — Other recurrent depressive disorders (depressive, recurrent, brief), F33.9 — Major depressive disorder, recurrent, unspecified (monopolar), F34.1 — Dysthymic disorder (nervous), F39 — Unspecified mood [affective] disorder (affective, mixed), F41.8 — Other specified anxiety disorders (anxiety), F43.21 — Adjustment disorder with depressed mood (situational), F44.89 — Other dissociative and conversion disorders (hysterical), F48.1 — Depersonalization-derealization syndrome (depersonalization), +24 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Thyroid Stimulating Hormone (TSH)

Contextual Map

Every relationship of F32.2 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run F32.2 with these 10 related codes in Claim Check

Hierarchy

• F01-F99 — Chapter 5: Mental, Behavioral and Neurodevelopmental Disorders (F01-F99) (F01-F99)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• F30-F39 — Mood [affective] disorders[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Referenced by Excludes1 notes

• F30 — Manic episode[Excludes1](via F32.-): “major depressive disorder, single episode (F32.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• F31 — Bipolar disorder[Excludes1](via F32.-): “major depressive disorder, single episode (F32.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R40.1 — Stupor[Excludes1](via F32.-): “depressive stupor (F31.-, F32.-, F33.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Excludes2 notes

• F06.3 — Mood disorder due to known physiological condition[Excludes2](via F32.-): “mood disorders, not due to known physiological condition or unspecified (F30-F39)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• F42 — Obsessive-compulsive disorder[Excludes2](via F32.-): “obsessive-compulsive symptoms occurring in depression (F32.-, F33.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• F63.2 — Kleptomania[Excludes2](via F32.-): “depressive disorder with stealing (F31.-, F32.-, F33.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• F90 — Attention-deficit hyperactivity disorders[Excludes2](via F32.-): “mood [affective] disorders (F30-F39)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• F91 — Conduct disorders[Excludes2](via F32.-): “mood [affective] disorders (F30-F39)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• F93.0 — Separation anxiety disorder of childhood[Excludes2](via F32.-): “mood [affective] disorders (F30-F39)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R53.83 — Other fatigue[Excludes2](via F32.-): “exhaustion and fatigue due to depressive episode (F32.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Clinical classification (CCSR)

• MBD002 — Depressive disorders[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)

Risk adjustment (CMS-HCC)

• HCC 155 — Major Depression, Moderate or Severe, without Psychosis [CMS-HCC]— CMS-HCC V28 · 2026

MS-DRG Grouper

• CC — Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (CC).”— CMS MS-DRG Definitions Manual (Appendix C) · FY2026
• DRG 885 — PSYCHOSES[MS-DRG]: “PSYCHOSES (MDC 19)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026

MDC crossing

• MDC 19 — Mental Diseases and Disorders[MDC crossing]: “Mental Diseases and Disorders — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

• Depression (acute) (mental), agitated (single episode)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Depression (acute) (mental), severe, single episode[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Depression (acute) (mental), vital (recurrent) (without psychotic symptoms), single episode[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Disorder (of), depressive, major, single episode, severe (without psychotic symptoms)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Episode, depressive, major, severe (without psychotic symptoms)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Menopause, menopausal (asymptomatic) (state), depression (single episode), agitated (single episode)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (11)

• F32 — Depressive episode[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• F32.0 — Major depressive disorder, single episode, mild[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• F32.1 — Major depressive disorder, single episode, moderate[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• F32.3 — Major depressive disorder, single episode, severe with psychotic features[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• F32.4 — Major depressive disorder, single episode, in partial remission[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• F32.5 — Major depressive disorder, single episode, in full remission[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• F32.8 — Other depressive episodes[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• F32.81 — Premenstrual dysphoric disorder[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• and 3 more

Change history

• FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data

CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page

Claim edits Official source data

CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page

Inpatient payment groups Official source data

CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page

Risk adjustment Official source data

2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release Release, file and checksum · Publisher’s page

Change history and date-of-service validity Official source data

CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page

Comparisons, relationships and the contextual map MedCoder structured relationship

Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears

Summary and FAQ answers MedCoder explanation

Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Nearest Codes in This Family

Official ICD-10-CM classifications closest to F32.2 in its code family, with their registry titles.

• F32 — Depressive episode
• F32.0 — Major depressive disorder, single episode, mild
• F32.1 — Major depressive disorder, single episode, moderate
• F32.3 — Major depressive disorder, single episode, severe with psychotic features
• F32.4 — Major depressive disorder, single episode, in partial remission
• F32.5 — Major depressive disorder, single episode, in full remission
• F32.8 — Other depressive episodes
• F32.81 — Premenstrual dysphoric disorder
• F32.89 — Other specified depressive episodes
• F32.9 — Major depressive disorder, single episode, unspecified

View all codes in the F32 family