F03.92 — Unspecified dementia, unspecified severity, with psychotic disturbance
F03.92 is a billable, specific ICD-10-CM code for unspecified dementia, unspecified severity, with psychotic disturbance. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Unspecified dementia, unspecified severity, with psychotic disturbance such as hallucinations, paranoia, suspiciousness, or delusional state
Risk adjustment
F03.92 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 127 Dementia, Mild or Unspecified0.341 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
F03.92 is named in 18 Medicare coverage policies — 17 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
- A53134Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions
- A54111Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
- A56641Billing and Coding: Home Health Skilled Nursing Care-Teaching and Training: Alzheimer's Disease and Behavioral Disturbances
How F03.92 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 F03.92.
- Dementia›with›psychotic disturbance(delusional state) (hallucinations) (paranoia) (suspiciousness)
Related codes at this level
Codes that share F03.9. If F03.92 is not quite right, the correct code is usually one of these.
- F03.90Unspecified dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
- F03.91Unspecified dementia, unspecified severity, with behavioral disturbance
- F03.93Unspecified dementia, unspecified severity, with mood disturbance
- F03.94Unspecified dementia, unspecified severity, with anxiety
Questions about F03.92
- Is F03.92 a billable ICD-10-CM code?
- Yes. F03.92 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does F03.92 sit in the tabular list?
- Mental, Behavioral and Neurodevelopmental disorders (F01-F99), in the block Mental disorders due to known physiological conditions (F01-F09).