F02.B4

F02.B4: Dementia in other diseases classified elsewhere, moderate, with anxiety

Billable / specific codeICD-10-CM

F02.B4 is a billable, specific ICD-10-CM code for dementia in other diseases classified elsewhere, moderate, with anxiety. It is valid for submission on a claim.

Check F02.B4 with the rest of the claim: free scrubber

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Major neurocognitive disorder in other diseases classified elsewhere, moderate, with anxiety

Excludes1 inherited from the categories above F02.B4

A category’s note binds every code beneath it.

Written on F02: Dementia in other diseases classified elsewhere

mild neurocognitive disorder due to known physiological condition with or without behavioral disturbance (F06.7-)

Excludes2 inherited from the categories above F02.B4

Not part of this code, but both may be coded when both are present.

Written on F02: Dementia in other diseases classified elsewhere

dementia in alcohol and psychoactive substance disorders (F10-F19, with .17, .27, .97)
vascular dementia (F01.5-, F01.A-, F01.B-, F01.C-)

Other codes that can never be billed with F02.B4

Their own Excludes1 notes name this code, so the conflict is not listed above.

F06.7Mild neurocognitive disorder due to known physiological condition
G31.84Mild cognitive impairment of uncertain or unknown etiology

Risk adjustment

F02.B4 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 126 Dementia, Moderate0.341 RAF

Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.

Medicare coverage

F02.B4 is named in 12 Medicare coverage policies: 11 listing it as supporting medical necessity, and 1 listing it as NOT covered. Which one applies depends on your Medicare contractor.

A52434Health and Behavior Assessment/Intervention – Medical Policy Articlenot covered
A54111Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
A56612Billing and Coding: CT of the Head
A56865Billing and Coding: Psychiatric Inpatient Hospitalization