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Bipolar Disorder E018

Document
Last amended 
28 September 2017
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
Brief description

Bipolar disorder is a mood disorder that is characterised by episodes of mania, hypomania, and depression.  There are two main subtypes, Bipolar I (with manic episodes) and Bipolar II (with hypomania but without manic epidoses).

Confirming the diagnosis

Making the diagnosis is difficult.  The majority of patients present first with major depression and may be diagnosed with that condition initially.  Diagnosis of bipolar disorder may then be delayed until manifestations of hypomania or mania subsequently develop.  In this event a diagnosis of bipolar disorder would then replace a diagnosis of depressive disorder (and would not be an additional diagnosis).

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

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 - Depressive disorder SOP
  • substance-induced mood disorder with depressive features only - Depressive disorder SOP
  • mood disorder due to a general medical condition with depressive features only - Depressive disorder SOP
Clinical onset

Once diagnosis has been confirmed clinical onset can be backdated to the time of the first relevant episode of mania, hypomania or depression.  The correct diagnosis may not be established until years after the onset of symptoms.

Clinical worsening

Clinical worsening may be evidenced by an increase in the frequency or severity of episodes.