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Bipolar Disorder E018

Document
Last amended 
12 September 2016
Current RMA Instruments:
Reasonable Hypothesis SOP 27 of 2009
Balance of Probabilities SOP
28 of 2009
Changes from Previous Instruments:

SOP Bulletin 134

ICD Coding:

  • ICD-9-CM Codes: 292.85, 293.84, 296.0, 296.4, 296.5, 296.6, 296.7, 296.80, 296.89, 301.10, 301.11, 301.13
  • ICD-10-AM Codes: F06.4, F19.9, F30.10-11, F31, F34.00-.01, F34.8
Is specific diagnostic evidence required to apply the SOP? – Yes.

A report from a specialist psychiatrist that conforms with the Repatriation Commission Guidelines for Psychiatric Compensation Claims is required for diagnosis.

Are there sub-factors that require specific information? – Yes.

All the onset factors are for specific types of bipolar disorder.

Additional diagnoses covered by SOP
  • bipolar I disorder
  • bipolar II disorder
  • cyclothymia
  • manic depression
  • alcohol-induced mood disorder with manic or mixed features
  • substance-induced mood disorder with manic or mixed features
  • mood disorder due to a general medical condition with manic or mixed features
Conditions not covered by SOP
  • alcohol-induced mood disorder with depressive features only, ICD code 292.84
  • substance-induced mood disorder with depressive features only, ICD code 292.84
  • mood disorder due to a general medical condition with depressive features only, ICD code 293.83
Unconfirmed diagnosis

If, after applying the above information, you are unable to confirm the diagnosis, you should then:

  1. obtain a report from a specialist psychiatrist, or;
  2. apply the second opinion protocol, or;
  3. re-encode the condition, if appropriate.