F02.C18: Dementia in other diseases classified elsewhere, severe, with other behavioral disturbance
F02.C18 is a billable, specific ICD-10-CM code for dementia in other diseases classified elsewhere, severe, with other behavioral disturbance. It is valid for submission on a claim.
Check F02.C18 with the rest of the claim: free scrubberUse additional code
Add a secondary code to capture the detail described below.
- code, if applicable, to identify wandering in dementia in conditions classified elsewhere (Z91.83)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Dementia in other diseases classified elsewhere, severe, with behavioral disturbances such as sleep disturbance, social disinhibition, or sexual disinhibition
- Major neurocognitive disorder in other diseases classified elsewhere, severe, with behavioral disturbances such as sleep disturbance, social disinhibition, or sexual disinhibition
Excludes1 inherited from the categories above F02.C18
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above F02.C18
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with F02.C18
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
F02.C18 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.C18 is named in 16 Medicare coverage policies: 15 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
- A53052Billing and Coding: Home Health Speech-Language Pathology
- A53057Billing and Coding: Home Health Occupational Therapy
- A53064Billing and Coding: Outpatient Occupational Therapy
Alphabetic index entries that lead here
- Dementia›in›diseases specified elsewhere›severe›with›behavioral disturbances(sexual disinhibition) (sleep disturbance) (social disinhibition)
- Dementia›in›diseases specified elsewhere›severe›with›behavioral disturbances›specified NEC
Code history
Unchanged in every release from FY2024 to FY2027.