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F03.90ICD-10-CM

Unspecified dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety

BillableMaps to an HCCDescriptor rewritten in 2022Adults only

How the code is built

F

Chapter

Mental, behavioral and neurodevelopmental disorders

03

Category

Unspecified dementia

9

Char 4

Severity not stated

0

Char 5

No behavioral, psychotic, mood, or anxiety disturbance

Chapter

F01 to F99

Mental, behavioral and neurodevelopmental disorders

Block

F01 to F09

Mental disorders due to known physiological conditions

Category

F03

Unspecified dementia, not billable on its own

Billable

Yes

Complete at 5 characters

Inclusion term

Dementia NOS

The index default for the unqualified term

Age edit

Adults only

Per the Medicare Code Editor

Risk adjustment

HCC mapped

The mild or unspecified dementia category under CMS-HCC V28

DefinitionCode structureClinical pictureDocumentationDecision guideTabular listComparisonClaim contextRisk adjustmentDenialsSources

Key takeaways

  • F03.90 codes dementia when the record names no cause, stages no severity, and documents no neuropsychiatric feature
  • Dementia NOS classifies here, so a bare dementia note lands on this code
  • The final character is a positive assertion that four features are absent, not a blank
  • The descriptor was rewritten in 2022, and templates carrying the old wording describe a code that no longer exists in that form
  • It is billable, and it maps to an HCC, but it will not support the therapies that require a specific diagnosis
1Definition

What ICD-10 code F03.90 means

F03.90 is the ICD-10-CM code for unspecified dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety. It applies when a provider has diagnosed dementia but has not named the underlying cause, has not staged the severity, and has documented none of the four neuropsychiatric features the descriptor lists.

Dementia NOS is the inclusion term, and the Alphabetic Index routes the unqualified term here, which makes F03.90 the default for a chart saying nothing more than dementia.

Code

F03.90

Descriptor

Unspecified dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety

Chapter

Mental, behavioral and neurodevelopmental disorders

Block

Mental disorders due to known physiological conditions

Category

F03, unspecified dementia

Billable

Yes

Inclusion term

Dementia NOS

Age edit

Adults, per the Medicare Code Editor

The descriptor was rewritten effective October 2022, and the change was substantial. Before that date, this code read unspecified dementia without behavioral disturbance. The revision added the severity axis and widened the excluded features from behavioral disturbance alone to behavioral, psychotic, mood, and anxiety disturbance. Any internal guidance, encounter form, or EHR favorites list still carrying the earlier wording is describing a code that no longer exists in that form.

2Code structure

Two axes, and this code is the corner

F03.90 has no subdivisions. The category is organised as two axes crossed with each other, and every billable code is a cell in that grid.

Axis 1, severity

Character 4

F03.9-

Severity not stated; this is the code

This code

F03.A-

Mild

F03.B-

Moderate

F03.C-

Severe

Axis 2, neuropsychiatric disturbance

Character 5 and beyond

0

None documented

11

With agitation

18

Other behavioral disturbance

2

Psychotic disturbance

3

Mood disturbance

4

Anxiety

Cross the two, and every combination has a code. F03.90 is the cell where neither axis was documented, and every step away from that corner is a step the record can usually support.

The final character is a positive statement, not a blank. Character 0 asserts that no behavioral, psychotic, mood, or anxiety disturbance is present. A note that simply never mentions those features is weaker support than one that says they are absent, and that distinction is what an auditor reads.

A third variable sits outside the grid entirely. F03 means no cause is documented. Once a cause appears, the encounter leaves this category: vascular dementia to F01.5-, and dementia in a named disease such as Alzheimer's or Parkinson's to F02.8-, with the underlying disease coded first.

3Clinical picture

Clinical findings documented under F03.90

A record supporting this code describes cognitive decline with functional impact and no stated cause.

Memory

Repeated questions, misplaced items, poor recall of recent events, reliance on an informant

Language

Word-finding difficulty, naming difficulty, reduced conversational output

Executive function

Trouble managing medications, finances, or appointments

Visuospatial

Getting lost on familiar routes, difficulty dressing or driving

Orientation and attention

Disorientation to time or place, reduced ability to sustain focus

Function

Declining independence in daily activities

What separates F03.90 from its siblings is what the note leaves out. No agitation, no hallucinations or delusions, no mood disturbance, no anxiety. Once any of those appears in the assessment, the encounter belongs to a different fifth character.

4Documentation

What the chart must show

  • A provider-stated diagnosis of dementia in the assessment, not a symptom such as memory loss or confusion
  • Cognitive findings linked to functional decline, ideally with a standardized instrument and its score
  • Collateral history where the patient is a poor historian
  • Duration and course, separating chronic decline from an acute change
  • Workup addressing reversible contributors, including medication review and relevant laboratory studies
  • An explicit statement that no behavioral, psychotic, mood, or anxiety disturbance is present
  • Evidence that severity was considered, or a statement that it was not determined
  • Any underlying disease, since that moves the code out of this category

A dementia entry sitting in the past medical history, with nothing in the assessment or plan, does not support reporting the code for that encounter.

5Decision guide

When to assign F03.90, and when not to

Dementia, no cause, no stage, no behavioral features

F03.90

Dementia, moderate, no cause or behavioral features

F03.B0

Dementia with agitation

F03.911

Dementia with hallucinations or delusions

F03.92

Dementia with mood disturbance

F03.93

Dementia with anxiety

F03.94

Alzheimer's dementia

G30.9 first, then F02.80

Vascular dementia

The applicable F01.5- code

Memory loss with no dementia diagnosis stated

The documented symptom code

Mild cognitive impairment

G31.84, which is not dementia

Delirium superimposed on dementia

F05, with the dementia code sequenced first

Wandering documented alongside dementia

F03.90 plus the wandering code

Two sequencing points decide most of these. When an underlying disease is named, the etiology code leads and the dementia code follows as the manifestation. When delirium is documented on top of dementia, the delirium code carries a code-first instruction naming the dementia range.

Query rather than default when the chart contains testing scores, functional staging language, or documented agitation, wandering, or hallucinations that the assessment never carried forward.

6Tabular list

Instructional notes at F03 and above

Inclusion term at F03.90

Dementia NOS

Inclusion terms at F03

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

Excludes2 at F03

Dementia with delirium or acute confusional state (F05)

Excludes2 at F03

Mild memory disturbance due to known physiological condition (F06.8)

Code first at F05

The underlying physiological condition, such as dementia, naming the F03.9 range

Both notes at F03 are Excludes2, which makes both permissions rather than prohibitions. The excluded condition is not part of F03, but a patient may carry both, and both may be reported when the documentation supports it. Coders drop these codes defensively on the assumption of a conflict that does not exist.

The delirium relationship runs in both directions and is worth reading carefully. F03 lists delirium as an Excludes2, and the delirium code separately carries a code-first instruction naming the dementia range. So a patient with delirium superimposed on dementia carries both codes, with the dementia sequenced first.

The legacy inclusion terms matter more than they look. Senile dementia, presenile dementia, and primary degenerative dementia are all inclusion terms at the category, which means older clinical phrasing classifies here rather than being unclassifiable. A note using any of them has documented dementia with no cause named.

7Comparison

Codes frequently confused with F03.90

F03.911, F03.918

Descriptor

Unspecified dementia, unspecified severity, with agitation and with other behavioral disturbance

Use instead when

A behavioral disturbance is documented

F03.92, F03.93, F03.94

Descriptor

The same, with psychotic, mood and anxiety disturbance

Use instead when

That feature is documented

F03.A0, F03.B0, F03.C0

Descriptor

Unspecified dementia, mild, moderate and severe, without disturbance

Use instead when

Severity is staged, but the cause is unstated

F01.5-

Descriptor

Vascular dementia

Use instead when

Dementia is attributed to cerebrovascular disease

F02.8-

Descriptor

Dementia in other diseases classified elsewhere

Use instead when

An underlying disease is documented and coded first

G30.9

Descriptor

Alzheimer's disease, unspecified

Use instead when

Alzheimer's is named, sequenced ahead of the manifestation code

G31.84

Descriptor

Mild cognitive impairment, as stated

Use instead when

MCI is documented, which is not dementia

F05

Descriptor

Delirium due to known physiological condition

Use instead when

An acute confusional state is present, reportable alongside

F06.8

Descriptor

Other specified mental disorders due to known physiological condition

Use instead when

Mild memory disturbance is documented, reportable alongside

R41.0, R41.3

Descriptor

Disorientation unspecified, other amnesia

Use instead when

A symptom is documented without a dementia diagnosis

Z91.83

Descriptor

Wandering in diseases classified elsewhere

Use instead when

Wandering is documented, reported with the dementia code first

The mild cognitive impairment row does more work than it appears to. MCI is not dementia and carries no risk adjustment value of its own, but it is the population that certain Alzheimer's therapies are approved for, which the coverage section below explains.

8Claim context

Services commonly reported with F03.90

F03.90 supports office and specialty evaluation and management, cognitive assessment and care planning, neurobehavioral status examination, neuropsychological testing, and advance care planning. The Medicare annual wellness visit includes detection of cognitive impairment as a required element, which is where many of these diagnoses originate.

Cognitive assessment and care planning carries a substantial documentation burden of its own, requiring a standardized instrument, a functional and safety assessment, an identified caregiver, and a written care plan. Neuropsychological testing services are time-based and carry separate evaluation and administration codes.

The national coverage picture for Alzheimer's therapy is where this code fails hardest. Monoclonal antibodies directed against amyloid are governed by a national determination that covers them only under coverage with evidence development, and only for patients with a clinical diagnosis of mild cognitive impairment due to Alzheimer's disease or mild Alzheimer's dementia, in both cases with confirmed amyloid pathology. Outside those pathways, the therapy is nationally non-covered.

Every element of that criterion is something F03.90 does not state. It names no cause, so it does not establish Alzheimer's. It stages no severity, so it does not establish mild disease. A claim or authorization built on this code contradicts the requirement on two axes at once.

Amyloid imaging moved from national to local. The national determination that formerly governed beta amyloid positron emission tomography was removed, ending the evidence development requirement and the once-per-lifetime limit, and returning coverage decisions to the contractors. Practices working from guidance written before that change will find the old restrictions no longer apply, and the current rules in their jurisdiction instead.

Confirm the national determination for anti-amyloid therapy, and the contractor's determination for amyloid imaging and neuropsychological testing.

9Risk adjustment

What F03.90 does to a risk score

The code pays, and the model separates severity above it

F03.90 maps to the mild or unspecified dementia category under the current model, which reached full phase-in for payment year 2026.

The model carries three dementia categories, separating severe and moderate from mild and unspecified.

Report it every year.

Risk adjustment does not carry a condition forward. A dementia diagnosis captured last year contributes nothing to this year's score unless it is documented and reported again at a face-to-face encounter.

Mild cognitive impairment is not a substitute.

That code carries no risk adjustment value at all, so a note saying MCI when the provider means dementia produces no capture, and the difference is invisible on the claim.

The audit exposure runs the other way.

A dementia code pulled from a problem list with no supporting assessment in the encounter note is the pattern risk adjustment validation and inspector general reviews look for first. Dementia is chronic and almost always present, which makes it among the conditions most likely to be carried forward without support.

Verify the category against the payment year.

The model renumbered categories in the transition from the previous version, so an internal crosswalk built for an earlier payment year will show a different number for the same condition.

10Denials

Coding errors that cause denials

Defaulting to F03.90 when the note names Alzheimer's, Parkinson's, or cerebrovascular disease

Sequence the etiology code first, then the manifestation code

Coding F03.90 when agitation, hallucinations, mood change, or anxiety is documented

Move to the applicable fifth character

Coding F03.90 when severity is staged in the note

Assign the mild, moderate, or severe code to match

Reporting dementia from the problem list with no assessment

Report only when the encounter evaluates, addresses, or treats the condition

Coding F03.90 for documented mild cognitive impairment

Assign the MCI code, and query if a dementia diagnosis was intended

Dropping the delirium code on an assumed conflict

Report both, since the note is an Excludes2 and delirium carries a code-first instruction

Coding F03.90 for a patient below the age edit

Review, since the code is restricted to adults

Working from pre-2022 descriptor language in templates

Update encounter forms and EHR favorites to the current descriptor

Requesting anti-amyloid therapy authorization under F03.90

Report the diagnosis the national determination requires, with the amyloid confirmation documented

Relying on a pre-transition crosswalk for the risk adjustment category

Verify against the current payment year model file

11Sources

Where to verify F03.90

ICD-10-CM Official Guidelines for Coding and Reporting

Etiology and manifestation sequencing, the Excludes2 definition, and the criteria for reporting other diagnoses

ICD-10-CM Tabular List at F03, F02 and F05

The inclusion terms, both Excludes2 notes, and the code-first instruction at the delirium code

CMS ICD-10 code page and the FY 2026 files

Current code files, the annual addenda, the Medicare Code Editor age edit, and the October 2022 descriptor revision

CMS Medicare Advantage rates and statistics

The current payment year model file and the three dementia categories it carries

NCD 200.3, Monoclonal Antibodies Directed Against Amyloid for the Treatment of Alzheimer's Disease

The covered population, the evidence development requirement, and the nationally non-covered indications

Medicare Coverage Database

Search your contractor's determinations for amyloid imaging, which returned to contractor discretion, and for neuropsychological testing.

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Last reviewed August 2026

This page is a free reference for billing and coding teams and is not coding, legal, or clinical advice. Code selection depends on the documentation in the record and on the policy of the payer being billed. Verify every code, instructional note, and sequencing rule against the current ICD-10-CM files and the Official Guidelines for Coding and Reporting for the applicable date of service. ICD-10-CM is maintained by the CDC's National Center for Health Statistics and published by CMS. CPT is a registered trademark of the American Medical Association. TruCare is not affiliated with CMS, NCHS, the AHA, or the AMA.

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