Specifiers

• Coding specifiers is done when diagnosing bipolar I disorder. There are different types of bipolar I disorder and the specifier digits help to distinguish which type is diagnosed. Fourth digit specifiers classify the most recent mood episode as either single manic episode (0), recurrent manic episodes (4), major depressive episodes (5), mixed episodes (6) or unspecified episodes (7). The fifth digit specifiers describe the severity of symptoms and can be mild (1), moderate (2), severe without psychosis (4) or severe with psychosis (5).
  
  

296.xx: Bipolar I Disorder

• Coding bipolar I disorder according to the DSM-IV begins with 296 as the first three digits to indicate the mood disorder as bipolar. The fourth and fifth digits are specifiers. An example of a bipolar I disorder diagnosis may be bipolar I disorder, mixed, severe with psychosis (296.55).
  
  

296.89: Bipolar II Disorder

• Coding bipolar II disorder according to the DSM-IV is recorded as 296.89. This diagnostic code includes the features of both hypomanic and major depressive episodes. Bipolar II disorder has recurrent mood episodes that are typically less severe than bipolar I disorder. Psychotic symptoms are not present in bipolar II disorder.
  
  

301.13: Cyclothymic Disorder

• Coding cyclothymia according to the DSM-IV is recorded as 301.13. Cyclohtymia is characterized by fluctuating moods that include minor symptoms of mania and depression. The mood episodes are not severe enough to be classified as full blown mania or major depression.The mood cycles occur rapidly and fluctuate quickly.
  
  

296.80: Bipolar Disorder NOS

• Coding bipolar disorder, not otherwise specified (NOS) according to the DSM-IV is recorded as 296.80. Bipolar disorder NOS is diagnosed when criteria for the other types of conditions is unclear or the clinician is not sure how to specify the presenting symptoms.