diagnosis code for bipolar 297.53 bipolar 1 "severe" ?

My pdoc has mentioned possiblity of bipolar to me for a long time. Today she said that because I just had a manic episode and then a mixed episode, that I was "classic bipolar spectrum". However I did not ask for any other details (like Bipolar 1 or 2, etc.). Then when I left she gave me a prescription for an EKG and she wrote on it: 297.53 then I looked at her bill and she checked off "Bipolar I, last episode unspecified, severe, w/o psych" . I agree now that I am bipolar however don't know how she got the "severe" part. Does anyone know how doctors judge mild, moderate, severe? Severe seems just too much. I've never been hospitalized and the manic episode was not that bad compared to others I've heard about. I know I can ask her next time but thats in 5 weeks. Does anyone know how severe it has to be to be "severe"?

I was surprised also when I requested my medical forms and found out that I had been diagnosed as bipolar 1 instead of 2. I didn't consider mine that severe either. I was hospitalized but was initially for being suicidal. I think the key is the mixed episodes. I have had quite a few of those. It seems a lot medical sites list mixed episodes as usually a diagnosis of bipolar 1 over 2; and it could be considered more severe because the possibility of suicide can be higher. The depression is there but so is the energy to do something about it.

Here are some sites that include information about mixed episodes:
webmd.com/bipolar-disorder/guide/mixed-bipolar-disorder
nimh.nih.gov/health/publications/bipolar-disorder/index.shtml
psychcentral.com/lib/the-two-types-of-bipolar-disorder/000612helpguide.org
mental/bipolar_disorder_symptoms_treatment.htm
bipolarmixedstates.com/bipolarmixedstates.html

Comparing BP I and BP II and which is worse makes no logical sense .. Both have the ability to screw up your life .. Manic or depressive are both equally life altering. Learning to help yourself handle the problems Bipolar can bring is most important .

Yeah I wouldn't get too hung up on labels. When my inpatient pdoc changed my dx from BP 2 to BP 1 she told me that it was just "words on paper" and really didn't matter to me - just to my insurance company. She said I needed to focus on alleviating the symptoms rather than what they are labeled as.

Same would go for being labeled severe, I think - who cares if it's mild or severe? It still affects your life the same no matter how they label it. So focus on getting well.

:-)

yes i think the mixed states thing she definitely seemed to be concerned about. Also she took soooooo long thinking about the code before she wrote it, so maybe she was just not sure. Also I am thinking that she had to either say "severe no pychosis" or "severe w/pschosis" because I had a delusion/fantasy/not_sure_what_to_call_it that she was God. And I had just told her that. So it must have made some impression!!! (not to make light of this).

renie

As others have said, labels are labels but, I will give you an example of my "last" manic episode...in a 2 1/2 month period, I worked as a nurse over 590 hrs sleeping anywhere from 2 to 4 hrs a night 7 days a week average; however, there were cycles of wakefulness lasting 36 to 48 hrs before getting that 2 to 4 hrs of sleep. That was with me taking Seroquel, Ambien 10mg (2 tabs), Xanax 2mg, and Valarian Root 1590 along with my Topamax and Lithium and other Rx meds...I have now crashed and at the other end of the roller coaster. The last time this happened, I was hospitalized and the called the episode "severe". Don't know if that helps...hopes it gives some insight.

Labels determine what treatments are covered by insurance. I've been labeled BP 2, BP 1 and currently BP NOS because of general remission of symptoms.

I would ignore the "severe" label. Consentrate on educating yourself about your disorder and take your medication.

thanks everyone I know you are all right. I will try not to get hung up on this, but it is just so strange that she did not explain this to me, and she obviously gave it some thought. Maybe some people would overlook some diagnostic code on the paperwork. But I am the type of person (maybe like some of you) that have been wondering a very long time if they even have a diagnosis and researching every angle constantly. So to see somethign on paper like that is strange, alarming and a relief at the same time.

renie