The Intake

Insights for those starting, managing, and growing independent healthcare practices

ICD-10 Code F33.2

What is the code F33.2? 

F33.2 is a billable/specific ICD-10-CM code used to indicate a diagnosis of "Major depressive disorder, recurrent, severe without psychotic features." This code is part of the broader chapter covering Mental, Behavioral, and Neurodevelopmental disorders (F01-F99), specifically within category F33 Major depressive disorder, recurrent. Use this code for clinical documentation and billing purposes.

Detailed description of F33.2 

The diagnosis with F33.2 reflects a severe intensity of major depressive disorder that recurs over time without accompanying psychotic symptoms such as delusions or hallucinations. This classification underscores the significant impairment caused by the depression, affecting the patient's ability to function in daily life, yet distinguishing it from forms that involve psychosis.

Symptoms commonly associated with F33.2 

Individuals diagnosed with F33.2 experience a range of severe symptoms that significantly impede daily functioning and quality of life, including:

  • Persistent sadness or a depressed mood most of the day, nearly every day
  • Marked loss of interest or pleasure in all, or almost all, activities
  • Significant weight loss or gain, or decrease or increase in appetite
  • Insomnia or hypersomnia nearly every day
  • Psychomotor agitation or retardation
  • Fatigue or loss of energy
  • Feelings of worthlessness or excessive or inappropriate guilt
  • Diminished ability to think or concentrate, or indecisiveness
  • Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt

Other related ICD-10-CM codes include:

  • F33.0 (Major depressive disorder, recurrent, mild)
  • F33.1 (Major depressive disorder, recurrent, moderate)
  • F33.3 (Major depressive disorder, recurrent, severe with psychotic symptoms ) These codes indicate different levels of severity and the presence or absence of psychotic features in recurrent major depressive disorder.

Appropriate usage of F33.2 for billing 

F33.2 should be employed for billing purposes when a provider lists in their assessment that a patient has been diagnosed with recurrent major depressive disorder at a severe level without any psychotic features. 

Instructional guidelines for physicians/providers coding F33.2

It is a best practice to properly document and diagnose this to justify the use of this code, reflecting the severe impairment and the recurrent nature of the condition. However, you can still code without this documentation.

Category F33, Major depressive disorder, recurrent, has an "Excludes1" note for "bipolar disorder (F31-)”. When both bipolar disorder and major depressive disorder, recurrent moderate, have been diagnosed, assign only the code for bipolar disorder (F31-). A code for major depression would not be reported separately.

Common pitfalls in coding with F33.2

  • Misclassifying the severity of depression, particularly failing to distinguish between severe depression with and without psychotic features.
  • Inadequate documentation of the recurrent nature and severity of the episodes, which are necessary to justify the use of F33.2.

Key resources for F33.2 coding


The ICD-10-CM code F33.2 is used for accurately documenting cases of major depressive disorder that are recurrent and severe without psychotic features. Using this code facilitates appropriate clinical management, ensuring that patients receive the necessary care and support while also supporting accurate billing and healthcare documentation.

Subscribe to The Intake:
A weekly check-up for your independent practice