F01.518
BillableVascular dementia, unspecified severity, with other behavioral disturbance
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F01.518 an HCC code?
Yes. F01.518 maps to Dementia, Mild or Unspecified under the CMS-HCC V28 risk adjustment model.
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
MEAT Criteria for F01.518
For F01.518 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically — it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed F01.518 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F01.518 is the ICD-10-CM diagnosis code for vascular dementia, unspecified severity, with other behavioral disturbance. Dementia caused by reduced blood flow to the brain, with behavioral problems other than agitation (such as wandering, inappropriate behavior, or verbal outbursts). F01.518 sits in the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99), within the section covering mental disorders due to known physiological conditions (f01-f09).
Under the CMS-HCC V28 risk adjustment model, F01.518 maps to Dementia, Mild or Unspecified (HCC 127) with a community, non-dual, aged base RAF weight of 0.464. F01.518 was not retained as a payment HCC under the older V24 model, so V28 introduced or recategorized it during the 2024–2026 phase-in. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
Use this code when behavioral disturbances are present but are not specifically agitation. Because F01.518 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for F01.518 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code when behavioral disturbances are present but are not specifically agitation
- •Document the specific type of behavioral disturbance to support medical necessity
Clinical Significance
Vascular dementia with other behavioral disturbance captures behavioral symptoms other than agitation, such as wandering, inappropriate sexual behavior, hoarding, sleep disturbances, or verbal outbursts. These behaviors significantly complicate care and may require specialized dementia care settings.
Documentation Requirements
- ✓Diagnosis of vascular dementia with cerebrovascular etiology documented
- ✓Specific behavioral disturbance described (wandering, inappropriate behavior, sleep-wake disturbance, etc.)
- ✓Documentation that the behavioral disturbance is NOT primarily agitation (which has its own code)
- ✓Impact of behavior on daily functioning and safety
- ✓Management plan for the behavioral disturbance
- ✓Cognitive assessment results
Use Additional Code
- code, if applicable, to identify wandering in vascular dementia (Z91.83)
Commonly Confused Codes
- •F01.511 — Vascular dementia with agitation: use specifically when agitation is the behavioral disturbance
- •F01.50 — Vascular dementia without behavioral disturbance: use when no behavioral issues are present
- •F01.52 — Vascular dementia with psychotic disturbance: use when hallucinations or delusions are present
- •F01.53 — Vascular dementia with mood disturbance: use when depression or mood changes are the primary issue