Unspecified dementia F03-
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
- senility NOS (R41.81)
- mild memory disturbance due to known physiological condition (F06.8)
- senile dementia with delirium or acute confusional state (F05)
- 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.
ICD-10 codes as primary:
G20 – Parkinson’s disease
G30.0* – Alzheimer’s disease
with early onset
G30.1* – Alzheimer’s disease
with late onset
G31.83 – Dementia with Lewy
bodies, with Parkinsonism
*Use additional code to identify:
Delirium (F05), if applicable
Dementia (F02.-- codes), with or
without behavioral disturbance
Wandering (Z91.83), if applicable
F01 Vascular Dementia Vascular dementia as a result of infarction of the brain due to vascular disease, including hypertensive cerebrovascular disease. Code first the underlying physiological condition or sequelae of CVD. And use an additional code to identify wandering if applicable (Z91.83)
Best practices when documenting for dementia would include some or all of the following:
The type of Dementia; senile, presenile, vascular etc.
What is the underlying neurological condition?
Information regarding presence of delirium, delusions or depression.
Are there any behavioral disturbances present (e.g., aggressive, violent or combative behavior)?
Code first the underlying physiological condition present when using the following dementia codes. These code ranges are not to be used as the principal diagnosis: Vascular Dementia [F01.-- codes] Unspecified Dementia [F03.-- codes] Dementia In Diseases classified elsewhere [F02.-- codes] Delirium (F05) d/t known physiological condition Specified mental disorders (F06.0- F06.34, F06.4, F06.8) d/t known physiological condition Unspecified mental disorder F09 d/t known Phys condition (These codes may, however, be listed as secondary diagnoses) Special note: FY2023 ICD-10-CM expands above Dementia diagnosis codes from 6 codes to 72. Dementia severity (mild, moderate, severe) is now part of root diagnosis code assignment; behaviors assigned within each dementia type/severity subcategory. Effective 10-01-2022
The disease of Dementia has been organized into 3* subcategories (types) in ICD-10-CM, with a total of six codes (for with and without behaviors, by type): Vascular Dementia [F01.51/with; F01.50/without] Dementia in diseases classified elsewhere [F02.81/with; F02.80/without] Unspecified (or NOS) Dementia [F03.91/with; F03.90/without]
Effective with FY2023 ICD-10-CM (10-01-2022 ) Changes in Dementia diagnosis coding maintains these 3 subcategories for Dementia with expansion of dementia diagnosis codes from 6 to 72 .Effective with FY2023 ICD-10-CM (October 1st, 2022), each diagnosis subcategory for Dementia (with or without behaviors) expands to include the severity of the dementia as mild, moderate, severe or unspecified.
Mild dementia Clearly evident functional impact on daily life, affecting mainly instrumental activities. No longer fully independent/requires occasional assistance with daily life activities.
Moderate dementia Extensive functional impact on daily life with impairment in basic activities. No longer independent and requires frequent assistance with daily life activities.
Severe dementia Clinical interview may not be possible. Complete dependency due to severe functional impact on daily life with impairment in basic activities, including basic self-care
ALL Dementia Behaviors (with or without) only can be assigned diagnosis codes based on the dementia type and severity Dementia subcategory/type + severity [F01.-, F02.-, F03.-] [.A-, .B-, .C-] PLUS additional one to two final code digits, depending on behavior/s specified [2, 3, 4, 11, 18 or 0] full code details below
Dementia with behaviors, has 5 new diagnosis codes (per type/severity) for behavior specificity : -11 Agitation [such as, aberrant motor behavior such as restlessness, rocking, pacing, or exitseeking; verbal or physical behaviors such as profanity, shouting, threatening, anger, aggression, combativeness, or violence]
Dementia without behaviors also has new diagnosis codes assigned by type/severity. [-.A0, -.B0, -.C0] Dementia-without-behaviors existing diagnosis codes [F01.50, F02.80, F03.90] are revised for use only as Dementia (by type),
*In addition to these 3 subcategories, there are a few special diagnosis codes for when dementia is seen
Codes titled “other” or “other specified” are for use when the information in the medical record provides detail for which a specific code does not exist. Alphabetic Index entries with NEC in the line designate “other” codes in the Tabular List. These Alphabetic Index entries represent specific disease entities for which no specific code exists, so the term is included within an “other” code
Codes titled “unspecified” are for use when the information in the medical record is insufficient to assign a more specific code. For those categories for which an unspecified code is not provided, the “other specified” code may represent both other and unspecified.
Best Practice/CDI note: Be sure to state the condition for which the other/unspecified code is being selected when assigning other and unspecified diagnosis codes.
