F03.B2 — Unspecified dementia, moderate, with psychotic disturbance
F03.B2 is a billable, specific ICD-10-CM code for unspecified dementia, moderate, 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, moderate, with psychotic disturbance such as hallucinations, paranoia, suspiciousness, or delusional state
Excludes2 inherited from the categories above F03.B2
Also inherited, and the opposite of Excludes1: these conditions are not part of F03.B2, but a patient can have both, so you may code both.
Other codes that can never be billed with F03.B2
These codes carry an Excludes1 note pointing at F03.B2. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading F03.B2 alone.
Risk adjustment
F03.B2 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.
Medicare coverage
F03.B2 is named in 14 Medicare coverage policies — 13 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
- A56416Billing and Coding: Assays for Vitamins and Metabolic Function
How F03.B2 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.B2.
- Dementia›moderate›with›psychotic disturbance(delusional state) (hallucinations) (paranoia) (suspiciousness)
Code history
F03.B2 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share F03.B. If F03.B2 is not quite right, the correct code is usually one of these.
Questions about F03.B2
- Is F03.B2 a billable ICD-10-CM code?
- Yes. F03.B2 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does F03.B2 sit in the tabular list?
- Mental, Behavioral and Neurodevelopmental disorders (F01-F99), in the block Mental disorders due to known physiological conditions (F01-F09).