CPT 90853 + ICD-10 F31.81: Bipolar II disorder
Group psychotherapy billed with Bipolar II disorder — documentation requirements, denial reasons, modifiers, and reimbursement context.
Compatibility Notes
Appropriate for Bipolar II psychoeducation or IPSRT groups. This is a more specific code than F31.9 and is preferred when bipolar subtype is confirmed for each participant. Per-participant billing and individualized notes required. Most payers accept this for outpatient group settings.
Documentation Required
- ✓Per-participant attendance and Bipolar II diagnosis
- ✓Hypomania and depressive episode history confirmed per participant
- ✓Group content (psychoeducation, IPSRT) documented
- ✓Safety screen per participant
Common Denial Reasons
- ✗Bipolar II criteria not established per participant
- ✗Group billed as single claim
- ✗No individualized progress notes
Applicable Modifiers
Reimbursement Notes
OON UCR $50–$90 per participant. Bipolar II group therapy is well-accepted when evidence-based group modality is documented.
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