All PlansDocumentationMedium impact
Best Coding Practices: Major Depressive Disorder
Highmark·PA, NY, DE, WV · Psychiatry, Internal Medicine, Family Medicine +1 more·Coding
Effective date
Jun 25, 2026
We identified it
Jun 26, 2026
Summary
Highmark has issued new best coding practice guidance for Major Depressive Disorder (MDD) effective immediately. Providers must use ICD-10 codes F32 and F33 with documented severity and remission status based on PHQ-9 scores and clinical findings, eliminating use of 'unspecified' diagnoses. Annual severity assessments are now required to guide accurate diagnosis coding and treatment adjustments.
Action Required
Immediately: Billing and clinical teams must update encounter forms and documentation templates to require PHQ-9 score documentation and severity/remission status assessment for all MDD diagnoses. Providers must discontinue use of unspecified MDD codes and use only F32 (single episodes) or F33 (recurrent episodes) with appropriate severity modifiers. Ensure all MDD claims include documented PHQ-9 results and clinical findings. Direct providers to the Coding Education/HCC University page on the Provider Resource Center for detailed MDD coding resources. Claims submitted with unspecified or improperly coded MDD diagnoses may be subject to denial or rework.