ICD-10 F03.A0
Billable / Specific HCC v28: 52Unspecified dementia, mild, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
About ICD-10-CM F03.A0
ICD-10-CM code F03.A0 represents Unspecified dementia, mild, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F03). The 2026 edition of ICD-10-CM F03.A0 became effective on October 1, 2025.
Coding Tips for F03.A0
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
F03.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 F03.A0. Per CMS ICD-10-CM Tabular 2026.
- Dementia, mild, NOS
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.
Medicare LCD Coverage for F03.A0
Local Coverage Determinations (LCDs) from CMS MACs that list F03.A0 as a covered diagnosis.
Showing top 10 of 268 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing F03.A0.
5 Medicare
CPT Codes Commonly Billed with F03.A0
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- G0252 CMS LCD: Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions CMS LCD
- 78608 CMS LCD: Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions CMS LCD
- A9597 CMS LCD: Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions CMS LCD
- A9601 CMS LCD: Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions CMS LCD
- G0235 CMS LCD: Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions CMS LCD
- 78609 CMS LCD: Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions CMS LCD
- A9552 CMS LCD: Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions CMS LCD
- G0219 CMS LCD: Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions CMS LCD
- A9598 CMS LCD: Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions CMS LCD
- G0156 CMS LCD: Billing and Coding: Home Health - Psychiatric Care CMS LCD
Codes Adjacent To F03.A0
Other codes in section F01-F09 (Mental disorders due to known physiological conditions).
ICD-10 F03.A0, Billing FAQ
Is ICD-10 code F03.A0 billable? +
Yes, F03.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 F03.A0? +
ICD-10 F03.A0 includes: Dementia, mild, NOS.
Does F03.A0 affect Medicare Advantage HCC risk adjustment? +
Yes. F03.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 F03.A0? +
Procedures frequently paired with F03.A0 include: G0252, 78608, A9597, A9601, G0235.
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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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