Code Attributes
- Non-Billable/Non-Specific Code
Applicable To
- Major neurocognitive disorder NOS
- Presenile dementia NOS
- Presenile psychosis NOS
- Primary degenerative dementia NOS
- Senile dementia NOS
- Senile dementia depressed or paranoid type
- Senile psychosis NOS
Approximate Synonyms
- Dementia
- Dementia, mild
- Dementia, moderate
- Dementia, presenile
- Dementia, presenile with delirium
- Dementia, presenile with delusions
- Dementia, presenile with depression
- Dementia, senile
- Dementia, senile with delirium
- Dementia, senile with delusion
- Dementia, senile with depression
- Dementia, senile with paranoia
- Dementia, senile with psychosis
- Dementia, severe
- Dementia- degenerative- primary
- Early onset dementia with delusions
- Mild dementia
- Mixed dementia
- Moderate dementia
- Organic dementia
- Presbyophrenic psychosis
- Presenile dementia
- Presenile dementia with delirium
- Presenile dementia with depression
- Primary degenerative dementia
- Senile dementia
- Senile dementia with delirium
- Senile dementia with delusion
- Senile dementia with depression
- Senile dementia with paranoia
- Senile dementia with psychosis
- Severe dementia
Includes
- Arteriosclerotic dementia
- Major neurocognitive disorder due to vascular disease
- Multi-infarct dementia
Clinical Information
- A condition in which a person loses the ability to think, remember, learn, make decisions, and solve problems. Symptoms may also include personality changes and emotional problems. There are many causes of dementia, including alzheimer disease, brain cancer, and brain injury. Dementia usually gets worse over time.
- An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness.
- Dementia is the name for a group of symptoms caused by disorders that affect the brain. It is not a specific disease. People with dementia may not be able to think well enough to do normal activities, such as getting dressed or eating. They may lose their ability to solve problems or control their emotions. Their personalities may change. They may become agitated or see things that are not there. Memory loss is a common symptom of dementia. However, memory loss by itself does not mean you have dementia. People with dementia have serious problems with two or more brain functions, such as memory and language. Although dementia is common in very elderly people, it is not part of normal aging.many different diseases can cause dementia, including alzheimer's disease and stroke. Drugs are available to treat some of these diseases. While these drugs cannot cure dementia or repair brain damage, they may improve symptoms or slow down the disease.
- Loss of intellectual abilities in an elderly person, interfering with this person's activities.
- Loss of intellectual abilities interfering with an individual's social and occupational functions. Causes include alzheimer's disease, brain injuries, brain tumors, and vascular disorders.
- Loss of intellectual functions such as memory, learning, reasoning, problem solving, and abstract thinking while vegetative functions remain intact.
Type 2 Excludes:
- Mild memory disturbance due to known physiological condition (F06.8)
- Senile dementia with delirium or acute confusional state (F05)
Codes
- F03.9 Unspecified dementia, unspecified severity
- F03.90 Unspecified dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
- F03.91 Unspecified dementia, unspecified severity, with behavioral disturbance
- F03.911 Unspecified dementia, unspecified severity, with agitation
- F03.918 Unspecified dementia, unspecified severity, with other behavioral disturbance
- F03.92 Unspecified dementia, unspecified severity, with psychotic disturbance
- F03.93 Unspecified dementia, unspecified severity, with mood disturbance
- F03.94 Unspecified dementia, unspecified severity, with anxiety
- F03.A Unspecified dementia, mild
- F03.A0 Unspecified dementia, mild, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
- F03.A1 Unspecified dementia, mild, with behavioral disturbance
- F03.A11 Unspecified dementia, mild, with agitation
- F03.A18 Unspecified dementia, mild, with other behavioral disturbance
- F03.A2 Unspecified dementia, mild, with psychotic disturbance
- F03.A3 Unspecified dementia, mild, with mood disturbance
- F03.A4 Unspecified dementia, mild, with anxiety
- F03.B Unspecified dementia, moderate
- F03.B0 Unspecified dementia, moderate, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
- F03.B1 Unspecified dementia, moderate, with behavioral disturbance
- F03.B11 Unspecified dementia, moderate, with agitation
- F03.B18 Unspecified dementia, moderate, with other behavioral disturbance
- F03.B2 Unspecified dementia, moderate, with psychotic disturbance
- F03.B3 Unspecified dementia, moderate, with mood disturbance
- F03.B4 Unspecified dementia, moderate, with anxiety
- F03.C Unspecified dementia, severe
- F03.C0 Unspecified dementia, severe, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
- F03.C1 Unspecified dementia, severe, with behavioral disturbance
- F03.C11 Unspecified dementia, severe, with agitation
- F03.C18 Unspecified dementia, severe, with other behavioral disturbance
- F03.C2 Unspecified dementia, severe, with psychotic disturbance
- F03.C3 Unspecified dementia, severe, with mood disturbance
- F03.C4 Unspecified dementia, severe, with anxiety
ICD-10 Code F03 is classified under the category of "unspecified dementia without behavioral disturbance." This diagnostic code is part of the International Classification of Diseases, Tenth Revision (ICD-10), which is used globally for health management, including in the mental health sector.
Understanding and correctly utilizing ICD-10 codes is essential for accurate client diagnosis, billing, and insurance claims processing.
1. Accurately enter the diagnosis
When documenting a client's diagnosis, it's important to enter the correct ICD-10 code. For clients diagnosed with dementia where the subtype or specific cause is not specified or known, and where the individual does not exhibit behavioral disturbances, F03 would be the appropriate code to enter.
2. Submit accurate billing and insurance claims
Accurate coding directly impacts billing and the ultimate success of insurance claims. When you prepare billing documents or submit claims, make sure that the diagnosis code matches the treatment and sessions logged. For services provided to a client with a diagnosis of unspecified dementia (F03), include this code in the documentation submitted to insurance companies.
3. Keep detailed client records
Keeping detailed and accurate client records is a cornerstone of mental health practice management. The use of ICD-10 codes like F03 in client profiles helps maintain a clear and organized record of each client's diagnosis and treatment history. This allows for continuity of care, especially when coordinating with other healthcare professionals or if the client’s insurance provider requests documentation to justify the treatment provided.
4. Verify insurance
Before starting treatment, verify the client's insurance coverage. When verifying coverage, including the diagnosis code (such as F03 for unspecified dementia) can help determine if the specific treatment plans you have in mind are covered under the client's policy, particularly since some insurance plans have specific stipulations about what diagnoses they cover and the types of therapy or treatment modalities eligible for reimbursement.
Important considerations
Behavioral disturbances
The specification "without behavioral disturbance" is a key component of F03. If a client exhibits behavioral disturbances, a different code may be more appropriate. Ensure that the diagnosis reflects the client's condition accurately.
Documentation
Always maintain thorough documentation to support the use of any ICD-10 code, including F03. This includes clinical assessments, treatment plans, and progress notes. Such documentation is essential, not just for billing and insurance claims, but also for legal and accreditation purposes.
Stay updated
The ICD-10 codes are subject to updates and changes. Regularly check for updates to ensure you're using the most current codes.
Sources
- "ICD-10 Code for Unspecified dementia- F03- Codify by AAPC". Codify By AAPC. American Academy of Professional Coders, n.d., https://www.aapc.com/codes/icd-10-codes/F03?srsltid=AfmBOopyp9MHMU0x2nn4ZxQ2_lAtnbTxdkhJv8_jYXDReLc78L147i0Y. Accessed 27 Jan 2025.
- "2025 ICD-10-CM Diagnosis Code F03: Unspecified dementia". ICD10Data. ICD10Data, n.d., https://www.icd10data.com/ICD10CM/Codes/F01-F99/F01-F09/F03-/F03. Accessed 27 Jan 2025.
- "NCI Thesaurus". NCI Thesaurus. National Cancer Institute, n.d., https://ncithesaurus.nci.nih.gov/ncitbrowser/ConceptReport.jsp?dictionary=NCI%20Thesaurus&version=24.07e&ns=ncit&code=C4786. Accessed 27 Jan 2025.
- "NCI Metathesaurus". NCI metathesaurus. National Cancer Institute, n.d., https://ncimetathesaurus.nci.nih.gov/ncimbrowser/ConceptReport.jsp?dictionary=NCI%20Metathesaurus&code=C1969275. Accessed 27 Jan 2025.
- "Dementia | Effective Health Care (EHC) Program". Agency for Healthcare Research and Quality. Agency for Healthcare Research and Quality, n.d., https://effectivehealthcare.ahrq.gov/health-topics/dementia. Accessed 27 Jan 2025.
- "NCI Thesaurus". NCI Thesaurus. National Cancer Institute, n.d., https://ncit.nci.nih.gov/ncitbrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C34524&ns=ncit. Accessed 27 Jan 2025.