ICD-10 F03
Non-Billable HeaderUnspecified dementia
About ICD-10-CM F03
ICD-10-CM code F03 represents Unspecified dementia. This is a non-billable header code in the Mental, Behavioral, and Neurodevelopmental chapter (block F03). The 2026 edition of ICD-10-CM F03 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under F03. Per CMS ICD-10-CM Tabular 2026.
- 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
Type 2 Excludes
Not included here, the excluded code is not part of F03, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- dementia with delirium or acute confusional state (F05)
- mild memory disturbance due to known physiological condition (F06.8)
Medicare LCD Coverage for F03
Local Coverage Determinations (LCDs) from CMS MACs that list F03 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing F03.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but F03 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with F03
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To F03
Other codes in section F01-F09 (Mental disorders due to known physiological conditions).
ICD-10 F03, Billing FAQ
Is ICD-10 code F03 billable? +
No, F03 is a non-billable header code. Use a more specific child code from block F03 when submitting claims.
What other names or terms map to F03? +
ICD-10 F03 includes: Major neurocognitive disorder NOS; Presenile dementia NOS; Presenile psychosis NOS, and 4 more clinical synonyms.
What codes are Type 2 Excludes for F03? +
Type 2 Excludes (may be coded together when both conditions exist): dementia with delirium or acute confusional state (F05); mild memory disturbance due to known physiological condition (F06.8)
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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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