F03.B18: Unspecified dementia, moderate, with other behavioral disturbance
F03.B18 is a billable, specific ICD-10-CM code for unspecified dementia, moderate, with other behavioral disturbance. It is valid for submission on a claim.
Check F03.B18 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 unspecified dementia (Z91.83)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Unspecified dementia, moderate, with behavioral disturbances such as sleep disturbance, social disinhibition, or sexual disinhibition
Other codes that can never be billed with F03.B18
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
F03.B18 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 126 Dementia, Moderate0.341 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.B18 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›moderate›with›behavioral disturbances(sexual disinhibition) (sleep disturbance) (social disinhibition)
- Dementia›moderate›with›behavioral disturbances›specified NEC
Code history
Unchanged in every release from FY2024 to FY2027.