F02.C11 — Dementia in other diseases classified elsewhere, severe, with agitation
F02.C11 is a billable, specific ICD-10-CM code for dementia in other diseases classified elsewhere, severe, with agitation. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Dementia in other diseases classified elsewhere, severe, with aberrant motor behavior such as restlessness, rocking, pacing, or exit-seeking
- Dementia in other diseases classified elsewhere, severe, with verbal or physical behaviors such as profanity, shouting, threatening, anger, aggression, combativeness, or violence
- Major neurocognitive disorder in other diseases classified elsewhere, severe, with aberrant motor behavior such as restlessness, rocking, pacing, or exit-seeking
- Major neurocognitive disorder in other diseases classified elsewhere, severe, with verbal or physical behaviors such as profanity, shouting, threatening, anger, aggression, combativeness, or violence
Risk adjustment
F02.C11 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 125 Dementia, Severe0.341 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.
Medicare coverage
F02.C11 is named in 12 Medicare coverage policies — 11 listing it as supporting medical necessity, and 1 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- 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
How F02.C11 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to F02.C11.
- Dementia›in›diseases specified elsewhere›severe›with›aberrant motor behavior(exit-seeking) (pacing) (restlessness) (rocking)
- Dementia›in›diseases specified elsewhere›severe›with›agitation
- Dementia›in›diseases specified elsewhere›severe›with›verbal or physical behaviors(anger) (aggression) (combativeness) (profanity) (shouting) (threatening) (violence)
Related codes at this level
Codes that share F02.C1. If F02.C11 is not quite right, the correct code is usually one of these.
Questions about F02.C11
- Is F02.C11 a billable ICD-10-CM code?
- Yes. F02.C11 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does F02.C11 sit in the tabular list?
- Mental, Behavioral and Neurodevelopmental disorders (F01-F99), in the block Mental disorders due to known physiological conditions (F01-F09).