ICD-10 Codes for Depression: F32 and F33 Explained
Depression ICD-10 codes for FY2027: F32 single episode vs F33 recurrent, severity and remission digits, F32.9 vs F32.A, F34.1, and how to avoid denials.
Major depressive disorder is coded in F32 for a single episode and F33 for recurrent episodes, with the fourth and fifth characters carrying severity, psychotic features and remission. F32.9 is major depression, unspecified; F32.A is depression, unspecified. Persistent depressive disorder is F34.1. In Ona, the chosen code feeds the visit's draft claim.
Quick answer:
- Single episode or recurrent is the first decision: F32.- or F33.-. The two categories exclude each other, so a claim should never carry both.
- Severity, psychotic features and remission are built into the code itself. F33.1 is recurrent and moderate; F32.5 is a single episode in full remission.
- F32.9 and F32.A are both unspecified, but they mean different things. F32.9 says major depressive disorder, single episode; F32.A says depression with nothing more known.
The Depression Code Family at a Glance
Codes and descriptors below come from the FY2027 ICD-10-CM code descriptions and tabular list published by CMS, cross-checked on icd10data.com on October 22, 2026. The FY2027 set covers dates of service from October 1, 2026 to September 30, 2027.
| Code | Official FY2027 descriptor | Notes from the tabular list |
|---|---|---|
| F32.0 | Major depressive disorder, single episode, mild | |
| F32.1 | Major depressive disorder, single episode, moderate | |
| F32.2 | Major depressive disorder, single episode, severe without psychotic features | |
| F32.3 | Major depressive disorder, single episode, severe with psychotic features | Inclusion terms include single episode of psychotic depression |
| F32.4 | Major depressive disorder, single episode, in partial remission | |
| F32.5 | Major depressive disorder, single episode, in full remission | |
| F32.81 | Premenstrual dysphoric disorder | Excludes1: premenstrual tension syndrome (N94.3) |
| F32.89 | Other specified depressive episodes | Inclusion terms include atypical depression |
| F32.9 | Major depressive disorder, single episode, unspecified | Inclusion term: major depression NOS |
| F32.A | Depression, unspecified | Inclusion terms: depression NOS, depressive disorder NOS |
| 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 | Inclusion terms include MDD, recurrent, with psychotic features |
| F33.40 | Major depressive disorder, recurrent, in remission, unspecified | |
| F33.41 | Major depressive disorder, recurrent, in partial remission | |
| F33.42 | Major depressive disorder, recurrent, in full remission | |
| F33.8 | Other recurrent depressive disorders | Inclusion term: recurrent brief depressive episodes |
| F33.9 | Major depressive disorder, recurrent, unspecified | Inclusion term: monopolar depression NOS |
| F34.1 | Dysthymic disorder | Inclusion terms include persistent depressive disorder and dysthymia |
| F43.21 | Adjustment disorder with depressed mood | Listed as an Excludes2 under F32 |
| F53.0 | Postpartum depression | Sits in F53, disorders associated with the puerperium |
One quirk of the structure: F32 and F33 are categories, and F32.8 and F33.4 are subcategories. None of the four is a billable code. F33.4 needs a fifth character (F33.40, F33.41 or F33.42), while single-episode remission is a plain four-character code (F32.4 or F32.5). Billers who learned the pattern on one category and assume it holds on the other end up with an incomplete code.
F32 or F33: Single Episode Versus Recurrent
The category title of F32 in the US set is "Depressive episode", and its includes note lists single episodes: single episode of major depression, of reactive depression, of agitated depression and so on. F33, "Major depressive disorder, recurrent", lists recurrent episodes, including recurrent episodes of seasonal affective disorder.
The tabular list puts an Excludes1 note on F32 for recurrent depressive disorder (F33.-), and both categories carry Excludes1 notes for bipolar disorder (F31.-) and manic episode (F30.-). The FY2027 guidelines define Excludes1 as "NOT CODED HERE!", meaning the two codes are never reported together. In practice that means a patient's depression codes on one claim come from one category, and if the clinician's diagnosis moves to bipolar disorder, the F32 or F33 code comes off the chart rather than staying on beside an F31 code.
Whether an episode is single or recurrent is a clinical determination in the note. The coding job is to make sure the code says the same thing the note says. The alphabetic index makes the stakes visible: "disorder, depressive, major" with nothing else goes to F32.9, single episode, while "disorder, depressive, major, recurrent" goes to F33.9. One word in the documentation moves the claim between categories.
Reading the Fourth and Fifth Characters
Within each category, the characters after the decimal carry three pieces of information:
- Severity of the current episode. Mild (F32.0, F33.0), moderate (F32.1, F33.1) or severe (F32.2, F33.2).
- Psychotic features, at the severe level. F32.3 and F33.3. The tabular groups mood-congruent and mood-incongruent psychotic symptoms under the same code.
- Remission. Partial or full: F32.4 and F32.5 for a single episode, F33.41 and F33.42 for recurrent, and F33.40 when the record says recurrent and in remission without saying which.
Each of these is a documentation dependency. If the note does not state the severity, the coder cannot assign F33.1, and the claim falls back to F33.9. The FY2027 guidelines say to code to the highest level of specificity supported by the medical record documentation, and also that it is inappropriate to select a specific code the documentation does not support. Both halves of that sentence matter. Upcoding to a severity the note never mentions is a compliance problem, not a billing win.
F32.9 Versus F32.A: Two Unspecified Codes, Two Meanings
This pair confuses more superbills than anything else in the family.
F32.9, major depressive disorder, single episode, unspecified. The clinician has documented major depressive disorder, single episode, without severity. Its inclusion term is "major depression NOS".
F32.A, depression, unspecified. The documentation says depression, or depressive disorder, without establishing major depressive disorder at all. Its inclusion terms are "depression NOS" and "depressive disorder NOS", and the index sends the bare term "depression" here.
Both are billable. Section I.B.18 of the FY2027 guidelines states that unspecified codes "have acceptable, even necessary, uses" and should be reported when they most accurately reflect what is known at that encounter. A primary care visit that documents depression and refers out may well be F32.A. A psychiatric evaluation that documents a major depressive episode should not be.
Where payers come in is less predictable. Some payer policies list the diagnoses they accept for particular behavioral health services, and long runs of unspecified codes on ongoing treatment claims draw attention. The rules differ by payer and by service, so the reliable defense is the same everywhere: the claim carries the most specific code the note supports.
Persistent Depressive Disorder and the Neighbors
Several conditions that clinicians and patients call depression are coded outside F32 and F33.
F34.1, dysthymic disorder. Its inclusion terms include persistent depressive disorder, dysthymia, depressive neurosis and persistent anxiety depression. The index sends "disorder, depressive, persistent" here. F34.1 carries an Excludes2 for anxiety depression that is mild or not persistent, which is F41.8.
F43.21, adjustment disorder with depressed mood. F32 lists adjustment disorder (F43.2) as Excludes2, which under the guidelines means both may be reported when both conditions are documented.
F41.8, other specified anxiety disorders. Mixed anxiety and depressive disorder is an inclusion term here. ICD-10-CM has no F41.2.
F53.0, postpartum depression. Coded in the puerperium category, not in F32.
F06.31 and F06.32. Mood disorder due to a known physiological condition, with depressive features or with a major depressive-like episode. These sit in the F01-F09 block for conditions due to known physiological causes.
Screening encounters. Z13.31 is encounter for screening for depression. A PHQ-9 score on its own is a screening result, not a diagnosis.
What Changed for FY2027
Nothing in the depression codes. The CMS tabular addendum for FY2027 changes chapter 5 in two places only: a note under F02 and a new code, F64.A, gender identity disorder, in remission. F32, F33, F34 and F43.2 are unchanged, so any template built on last year's codes is still valid. If depression claims began rejecting after October 1, the annual update is not the cause. To look a code up yourself, the CDC's ICD-10-CM page links to the NCHS code browser.
Where Depression Claims Go Wrong
Most problems with these codes are not exotic. They are the same handful, repeated:
- An incomplete code. F33.4, F32.8 or F33 on its own. All three are headings, not codes.
- Both categories on one claim. F32.1 and F33.1 together breaks the Excludes1 rule.
- A stale code. The clinician refined the diagnosis three visits ago and the claim still carries F32.A.
- A severity the note does not state. The claim says moderate, the note says nothing, and the record request turns into a recoupment.
- A service line with no diagnosis pointer. The claim has the code, but the psychotherapy line is not linked to it.
- Uncertain diagnoses on outpatient claims. Section IV.H tells outpatient coders not to code diagnoses documented as "probable", "suspected", "rule out" or "working diagnosis". Code what is established at that visit.
How the Code Moves From Chart to Claim in Ona
Ona is an AI-native, all-in-one practice management platform covering CRM, EHR and RCM on one patient record, used by behavioral health practices from solo therapists to multi-location groups. The point for depression coding is that the diagnosis is chosen once, on the chart, and the claim reads it from there.
Choosing the code. Add diagnosis searches by condition name or ICD-10 code and narrows level by level through the hierarchy, so "F33" opens into F33.4 and then into F33.41 rather than stopping halfway. Every row carries its billability: categories are labeled not billable, and Ona's help page states that a non-billable code cannot be added from the coded picker. Added during a visit, the diagnosis is saved with that visit.
Writing the note. AI charting drafts against DAP, BIRP or your own template, from the session recording, intake and chart. Nothing Ona proposes after the draft lands until the clinician keeps it, and signed notes lock, with later corrections recorded as amendments with a reason.
Building the claim. Ona Insurance keeps each insured visit's draft claim in sync with the chart, rebuilding as diagnoses, procedures and services change. The "Diagnosis codes on every line" billing rule requires every claim line to have a linked diagnosis code, and pre-submission errors block the claim until they are fixed. Eligibility runs at booking and again in the 48 hours before the visit.
Working what comes back. Payer reasons return as alerts with their adjustment codes, and a denied claim can be corrected as a linked replacement and resubmitted. The visit-to-claim path, including superbills for patients seeing you out of network, is set out in From visit billing to superbill and claim.
If the diagnosis on the chart is wrong rather than outdated, Ona does not let you edit the code in place. You archive it and add the correct one, which keeps an honest record of what was coded at each visit.
What It Costs
Diagnosis coding, charting and claims are included in the seat. Per Ona's pricing page, a practitioner seat is $130 per month and a staff seat $45, with 10% off for annual billing and a 14-day free trial with no credit card. Insurance billing adds an Ona Clearing House plan from $69 to $1,099 per month, each with unlimited providers and payer enrollments included. Group practices running several locations or five or more practitioners get custom pricing.
Coding guidance in this article is general and reflects the FY2027 code set per CMS; payer rules vary, so confirm specific requirements with the payer.
Frequently asked questions
What is the ICD-10 code for major depressive disorder?
It depends on the episode. A single episode is coded in F32, from F32.0 for mild to F32.5 for full remission, and F32.9 when severity is not documented. Recurrent major depressive disorder is coded in F33, from F33.0 to F33.42, and F33.9 when severity is not documented.
What is the difference between F32.9 and F32.A?
F32.9 is major depressive disorder, single episode, unspecified, used when major depressive disorder is documented without severity. F32.A is depression, unspecified, used when the record says depression or depressive disorder without establishing major depressive disorder. Both are billable.
What is the ICD-10 code for recurrent depression?
Recurrent major depressive disorder is F33. The billable codes are F33.0, F33.1, F33.2, F33.3, F33.40, F33.41, F33.42, F33.8 and F33.9. F33.9 is the code when recurrence is documented but severity is not.
Can F32 and F33 codes be billed together?
No. F32 carries an Excludes1 note for recurrent depressive disorder, F33. The FY2027 guidelines define Excludes1 as two codes that should never be reported together, so a claim carries either a single-episode code or a recurrent code.
What is the ICD-10 code for persistent depressive disorder?
F34.1, dysthymic disorder. Persistent depressive disorder and dysthymia are both listed as inclusion terms under it in the FY2027 tabular list, and the index sends persistent depressive disorder to F34.1.
Did the depression ICD-10 codes change for FY2027?
No. The CMS FY2027 tabular addendum changes chapter 5 only with a note under F02 and a new code, F64.A. The F32, F33 and F34 codes and descriptors are the same as in FY2026.
Next step
Bring a recurrent depression claim and its note to a 15-minute demo and follow the code from the diagnosis picker to the draft claim and the billing rules that check it. Or start the 14-day free trial from the pricing page, no credit card needed.
Written by
Ona Health team