Unspecified dementia
In Mental disorders due to known physiological conditions (F01-F09), chapter 5: Mental, Behavioral and Neurodevelopmental Disorders
24 billable codes under F03: 20 are a CC; all map to HCC 127 (Dementia, Mild or Unspecified), HCC 125 (Dementia, Severe), HCC 126 (Dementia, Moderate).A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment. An HCC counts toward a Medicare Advantage patient's risk score.
Also indexed as: Dementia), in, multiple, etiologies; Dementia), old age; Dementia), presenile; Dementia), primary degenerative; Dementia), senile; Dementia), senile, depressed or paranoid type; Depression, senile; Disorder, mental, presenile, psychotic; Disorder, mental, senile, psychotic NEC; Insanity, senile; Melancholia, senile; Old age, dementia; Paranoia, senile; Paranoid, dementia; Paranoid, psychosis, senile; Paranoid, state, senile; Presbyophrenia; Presenile, dementia; Psychosis, due to or associated with, presenile dementia; Psychosis, due to or associated with, senile dementia; Psychosis, paranoid, senile; Psychosis, presbyophrenic; Psychosis, presenile; Psychosis, senile NEC; Psychosis, senile NEC, depressed or paranoid type; Psychosis, senile NEC, simple deterioration; Reaction, paranoid, senile; Senile, with, mental changes NOS; State, paranoid, senile; State, psychotic, organic, senile or presenile
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Instructional notes
Includes: conditions that are coded here
- Major neurocognitive disorder NOS
- Presenile dementia NOS
- Presenile psychosis NOS
- Primary degenerative dementia NOS
- Senile dementia NOS
- Senile dementia depressed or paranoid type
- Senile psychosis NOS
Official coding guidelines
From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.
- Section I.C.5.d Dementia (page 45), covers F03
Code dementia (F01, F02, F03) by cause and by severity as the provider documents it; use unspecified severity when it is not stated. If it worsens during an inpatient stay, assign one code for the highest severity reached.
Other Chapter 5 topics:
All codes under F03
F03 can't be used on a claim. Pick a billable code below; grey headings group them.
- F03.9Unspecified dementia, unspecified severity
- F03.90Unspecified dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
- F03.91Unspecified dementia, unspecified severity, with behavioral disturbance
- F03.911Unspecified dementia, unspecified severity, with agitation
- F03.918Unspecified dementia, unspecified severity, with other behavioral disturbance
- F03.92Unspecified dementia, unspecified severity, with psychotic disturbance
- F03.93Unspecified dementia, unspecified severity, with mood disturbance
- F03.94Unspecified dementia, unspecified severity, with anxiety
- F03.AUnspecified dementia, mild
- F03.A0Unspecified dementia, mild, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
- F03.A1Unspecified dementia, mild, with behavioral disturbance
- F03.A11Unspecified dementia, mild, with agitation
- F03.A18Unspecified dementia, mild, with other behavioral disturbance
- F03.A2Unspecified dementia, mild, with psychotic disturbance
- F03.A3Unspecified dementia, mild, with mood disturbance
- F03.A4Unspecified dementia, mild, with anxiety
- F03.BUnspecified dementia, moderate
- F03.B0Unspecified dementia, moderate, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
- F03.B1Unspecified dementia, moderate, with behavioral disturbance
- F03.B11Unspecified dementia, moderate, with agitation
- F03.B18Unspecified dementia, moderate, with other behavioral disturbance
- F03.B2Unspecified dementia, moderate, with psychotic disturbance
- F03.B3Unspecified dementia, moderate, with mood disturbance
- F03.B4Unspecified dementia, moderate, with anxiety
- F03.CUnspecified dementia, severe
- F03.C0Unspecified dementia, severe, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
- F03.C1Unspecified dementia, severe, with behavioral disturbance
- F03.C11Unspecified dementia, severe, with agitation
- F03.C18Unspecified dementia, severe, with other behavioral disturbance
- F03.C2Unspecified dementia, severe, with psychotic disturbance
- F03.C3Unspecified dementia, severe, with mood disturbance
- F03.C4Unspecified dementia, severe, with anxiety
F03 MS-DRGs
As the principal diagnosis, the billable codes under F03 group to MS-DRG 884, 974, 975, or 976 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.
- DRG 884 Organic Disturbances and Intellectual Disability (24 of 24 codes)
- DRG 974 HIV with Major Related Condition with MCC (1 of 24 codes)
- DRG 975 HIV with Major Related Condition with CC (1 of 24 codes)
- DRG 976 HIV with Major Related Condition without CC/MCC (1 of 24 codes)
Other codes that refer to F03
Notes on these codes point to F03.
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Dementia
Dementia is a loss of mental functions that is severe enough to affect your daily life and activities. These functions include: It is normal to become a bit more forgetful as you age. But dementia is not a normal part of aging. It is a serious disorder that interferes with your daily life.
Read more about dementia on MedlinePlusCode history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.