F03.A2: Unspecified dementia, mild, with psychotic disturbance
F03.A2 is a billable, specific ICD-10-CM code for unspecified dementia, mild, with psychotic disturbance. It is valid for submission on a claim.
Check F03.A2 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Unspecified dementia, mild, with psychotic disturbance such as hallucinations, paranoia, suspiciousness, or delusional state
Excludes1 inherited from the categories above F03.A2
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above F03.A2
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with F03.A2
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
F03.A2 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
F03.A2 is named in 14 Medicare coverage policies: 13 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
- 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
- A56416Billing and Coding: Assays for Vitamins and Metabolic Function
Alphabetic index entries that lead here
- Dementia›mild›with›psychotic disturbance(delusional state) (hallucinations) (paranoia) (suspiciousness)
Code history
Unchanged in every release from FY2024 to FY2027.