ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 F01.C0

Billable / Specific HCC v28: 52

Vascular dementia, severe, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety

F01
Block
2
Synonyms
350
LCDs
15
Payer Policies
55
Linked CPTs

About ICD-10-CM F01.C0

ICD-10-CM code F01.C0 represents Vascular dementia, severe, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F01). The 2026 edition of ICD-10-CM F01.C0 became effective on October 1, 2025.

Coding Tips for F01.C0

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

HCC capture: document with MEAT each year

F01.C0 is a CMS-HCC v28 risk-adjustment code (category 52). 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.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under F01.C0. Per CMS ICD-10-CM Tabular 2026.

  • Major neurocognitive disorder due to vascular disease, severe, NOS
  • Vascular dementia, severe, NOS

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 52
ESRD-HCC
Category 52

Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.

Medicare LCD Coverage for F01.C0

Local Coverage Determinations (LCDs) from CMS MACs that list F01.C0 as a covered diagnosis.

350 LCDs

Showing top 10 of 350 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 92524 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 96112 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 92521 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 97130 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 97129 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 92597 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 97110 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 97533 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 96110 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 92522 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing F01.C0.

15 policies

5 Medicare

Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Policy ID: ART-54111
Billing and Coding: CT of the Head
Policy ID: ART-56612
Billing and Coding: Swallowing Studies for Dysphagia
Policy ID: ART-56621
Billing and Coding: Magnetic Resonance Angiography
Policy ID: ART-56775
Billing and Coding: Magnetic Resonance Angiography (MRA)
Policy ID: ART-56805

CPT Codes Commonly Billed with F01.C0

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

55 linkages
  • 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.C0

Other codes in section F01-F09 (Mental disorders due to known physiological conditions).

ICD-10 F01.C0, Billing FAQ

Is ICD-10 code F01.C0 billable? +

Yes, F01.C0 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.C0? +

ICD-10 F01.C0 includes: Major neurocognitive disorder due to vascular disease, severe, NOS; Vascular dementia, severe, NOS.

Does F01.C0 affect Medicare Advantage HCC risk adjustment? +

Yes. F01.C0 maps to CMS-HCC v28 category 52. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What CPT codes are commonly billed with F01.C0? +

Procedures frequently paired with F01.C0 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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