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

ICD-10 F02.A0

Billable / Specific HCC v28: 52

Dementia in other diseases classified elsewhere, mild, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety

F02
Block
2
Synonyms
247
LCDs
10
Payer Policies
37
Linked CPTs

About ICD-10-CM F02.A0

ICD-10-CM code F02.A0 represents Dementia in other diseases classified elsewhere, mild, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F02). The 2026 edition of ICD-10-CM F02.A0 became effective on October 1, 2025.

Coding Tips for F02.A0

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

HCC capture: document with MEAT each year

F02.A0 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 F02.A0. Per CMS ICD-10-CM Tabular 2026.

  • Dementia in other diseases classified elsewhere, mild, NOS
  • Major neurocognitive disorder in other diseases classified elsewhere, mild, 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 F02.A0

Local Coverage Determinations (LCDs) from CMS MACs that list F02.A0 as a covered diagnosis.

247 LCDs

Showing top 10 of 247 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 F02.A0.

10 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: Psychiatric Inpatient Hospitalization
Policy ID: ART-56865
Billing and Coding: Psychiatry and Psychology Services
Policy ID: ART-56937
Billing and Coding: Psychiatric Codes
Policy ID: ART-57130

CPT Codes Commonly Billed with F02.A0

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

37 linkages
  • 90865 CMS LCD: Billing and Coding: Psychiatric Codes CMS LCD
  • 90889 CMS LCD: Billing and Coding: Psychiatric Codes CMS LCD
  • G0451 CMS LCD: Billing and Coding: Psychiatric Codes CMS LCD
  • 90880 CMS LCD: Billing and Coding: Psychiatric Codes CMS LCD
  • 90839 CMS LCD: Billing and Coding: Psychiatric Codes CMS LCD
  • G0017 CMS LCD: Billing and Coding: Psychiatric Codes CMS LCD
  • 90840 CMS LCD: Billing and Coding: Psychiatric Codes CMS LCD
  • G0018 CMS LCD: Billing and Coding: Psychiatric Codes CMS LCD
  • G0560 CMS LCD: Billing and Coding: Psychiatric Codes CMS LCD
  • 90845 CMS LCD: Billing and Coding: Psychiatric Codes CMS LCD

Codes Adjacent To F02.A0

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

ICD-10 F02.A0, Billing FAQ

Is ICD-10 code F02.A0 billable? +

Yes, F02.A0 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 F02.A0? +

ICD-10 F02.A0 includes: Dementia in other diseases classified elsewhere, mild, NOS; Major neurocognitive disorder in other diseases classified elsewhere, mild, NOS.

Does F02.A0 affect Medicare Advantage HCC risk adjustment? +

Yes. F02.A0 maps to CMS-HCC v28 category 52. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What CPT codes are commonly billed with F02.A0? +

Procedures frequently paired with F02.A0 include: 90865, 90889, G0451, 90880, 90839.

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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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