F04: Amnestic disorder due to known physiological condition
F04 is a billable, specific ICD-10-CM code for amnestic disorder due to known physiological condition. It is valid for submission on a claim.
Check F04 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Excludes2: not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
Code first
The underlying condition must be sequenced before this code.
- the underlying physiological condition
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Korsakov's psychosis or syndrome, nonalcoholic
Other codes that can never be billed with F04
Their own Excludes1 notes name this code, so the conflict is not listed above.
- R41.3Other amnesia
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
F04 is named in 10 Medicare coverage policies: 9 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
- A56756Billing and Coding: Home Health - Psychiatric Care
- A56937Billing and Coding: Psychiatry and Psychology Services
- A57065Billing and Coding: Outpatient Psychiatry and Psychology Services
Alphabetic index entries that lead here
- Amnes(t)ic syndrome (post-traumatic)
- Meynert's amentia(nonalcoholic)
- Toxemica cerebropathia psychica(nonalcoholic)
- Amentia›Meynert's(nonalcoholic)
- Disease, diseased›Korsakoff's(nonalcoholic)
- Korsakoff's›nonalcoholic
- Psychosis, psychotic›Korsakoff's, Korsakov's, Korsakow's(nonalcoholic)
- Syndrome›Korsakoff(-Wernicke) (nonalcoholic)
- Syndrome›Wernicke-Korsakoff(nonalcoholic)
- Wernicke-Korsakoff's syndrome or psychosis›nonalcoholic
- Disorder›amnesic, amnestic›due to general medical condition(secondary to)
- Syndrome›organic›amnesic(not alcohol- or drug-induced)
Code history
Unchanged in every release from FY2024 to FY2027.