ICD-10 F01.53
Billable / Specific HCC v28: 51 CCVascular dementia, unspecified severity, with mood disturbance
About ICD-10-CM F01.53
ICD-10-CM code F01.53 represents Vascular dementia, unspecified severity, with mood disturbance. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F01). The 2026 edition of ICD-10-CM F01.53 became effective on October 1, 2025.
Coding Tips for F01.53
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
F01.53 is a CMS-HCC v28 risk-adjustment code (category 51). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.
F01.53 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under F01.53. Per CMS ICD-10-CM Tabular 2026.
- Major neurocognitive disorder due to vascular disease, unspecified severity, with mood disturbance such as depression, apathy, or anhedonia
- Vascular dementia, unspecified severity, with mood disturbance such as depression, apathy, or anhedonia
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Inpatient DRG Impact, CC
codes Vascular dementia, unspecified severity, with mood disturbance. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for F01.53
Local Coverage Determinations (LCDs) from CMS MACs that list F01.53 as a covered diagnosis.
Showing top 10 of 349 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing F01.53.
1 Cigna
5 Medicare
CPT Codes Commonly Billed with F01.53
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 97130 CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders CMS LCD
- 92608 CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders CMS LCD
- 97129 CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders CMS LCD
- 92607 CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders CMS LCD
- 96110 CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders CMS LCD
- 92524 CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders CMS LCD
- 92508 CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders CMS LCD
- 92597 CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders CMS LCD
- 92521 CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders CMS LCD
- 96105 CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders CMS LCD
Codes Adjacent To F01.53
Other codes in section F01-F09 (Mental disorders due to known physiological conditions).
ICD-10 F01.53, Billing FAQ
Is ICD-10 code F01.53 billable? +
Yes, F01.53 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What other names or terms map to F01.53? +
ICD-10 F01.53 includes: Major neurocognitive disorder due to vascular disease, unspecified severity, with mood disturbance such as depression, apathy, or anhedonia; Vascular dementia, unspecified severity, with mood disturbance such as depression, apathy, or anhedonia.
Does F01.53 affect Medicare Advantage HCC risk adjustment? +
Yes. F01.53 maps to CMS-HCC v28 category 51. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is F01.53 a CC or MCC for inpatient DRG? +
Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What CPT codes are commonly billed with F01.53? +
Procedures frequently paired with F01.53 include: 97130, 92608, 97129, 92607, 96110.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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