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.
Check F02.C11 with the rest of the claim: free scrubberInclusion 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
Excludes1 inherited from the categories above F02.C11
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above F02.C11
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with F02.C11
Their own Excludes1 notes name this code, so the conflict is not listed above.
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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
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 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
Alphabetic index entries that lead here
- 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)
Code history
Unchanged in every release from FY2024 to FY2027.