F01.A11 ICD-10-CM Code: Vascular dementia, mild, with agitation
F01.A11 maps to CMS-HCC V28 127. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC coding software
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FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Mental disorders due to known physiological conditions (F01-F09)
F01.A11
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceVascular dementia, mild, with agitation
This code describes a patient with early-stage dementia caused by reduced blood flow to the brain, who experiences mild memory and thinking problems along with restlessness or agitated behavior. The condition is not yet severe but is noticeable enough to affect daily functioning.
Buddy Insight
Mild vascular dementia with agitation indicates early-stage cerebrovascular cognitive decline with agitated behavior.
CMS-HCC V28
MappedHCC 127
Coefficient HCC 127: 0.341 (Community Non-Dual Aged (CNA))
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
Context neededHCC 51
Coefficient needs member context
RXHCC
Context neededHCC 112
Coefficient needs member context
Code Book Path
Inclusion Terms
Official- Major neurocognitive disorder due to vascular disease, mild, with aberrant motor behavior such as restlessness, rocking, pacing, or exit-seeking
- Major neurocognitive disorder due to vascular disease, mild, with verbal or physical behaviors such as profanity, shouting, threatening, anger, aggression, combativeness, or violence
- Vascular dementia, mild, with aberrant motor behavior such as restlessness, rocking, pacing, or exit-seeking
- Vascular dementia, mild, with verbal or physical behaviors such as profanity, shouting, threatening, anger, aggression, combativeness, or violence
- Vascular dementia as a result of infarction of the brain due to vascular disease, including hypertensive cerebrovascular disease.Inherited from F01
Excludes 2
Official- symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99)Inherited from F01-F99
Related Codes
Includes
Official- disorders of psychological developmentInherited from F01-F99, F01
- arteriosclerotic dementiaInherited from F01-F99, F01
- major neurocognitive disorder due to vascular diseaseInherited from F01-F99, F01
- multi-infarct dementiaInherited from F01-F99, F01
Excludes 1
Official- mild neurocognitive disorder due to known physiological condition with or without behavioral disturbance (F06.7-)Inherited from F01.A
Code First
Official- , if applicable, any causal conditionInherited from F01
Use Additional
OfficialNo Use Additional Code instructions are included in this display for F01.A11. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for F01.A11. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is F01.A11 an HCC code?
Yes. F01.A11 (Vascular dementia, mild, with agitation) maps to HCC 127, Dementia, Mild or Unspecified under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.341. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.
Coder answer: F01.A11 is billable and maps to V28 HCC 127, Dementia, Mild or Unspecified. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.
- Code
- F01.A11
- Description
- Vascular dementia, mild, with agitation
- HCC (V28)
- HCC 127 — Dementia, Mild or Unspecified
- RAF reference coefficient
- 0.341
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.
Work F01.A11 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for F01.A11
For F01.A11, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.
- 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
Coder workflow notes
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What This Code Means
F01.A11 is the ICD-10-CM diagnosis code for vascular dementia, mild, with agitation. This code describes a patient with early-stage dementia caused by reduced blood flow to the brain, who experiences mild memory and thinking problems along with restlessness or agitated behavior. The condition is not yet severe but is noticeable enough to affect daily functioning. F01.A11 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.A11 maps to Dementia, Mild or Unspecified (HCC 127) with a source-labeled community, non-dual, aged reference coefficient of 0.341. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.
Ensure documentation specifies both the severity level (mild) and the behavioral component (agitation) before assigning this code, as these are essential elements of the diagnosis. For F01.A11, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. 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, source-labeled coefficient references, and MEAT documentation criteria for F01.A11 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Ensure documentation specifies both the severity level (mild) and the behavioral component (agitation) before assigning this code, as these are essential elements of the diagnosis
- •Verify that the dementia is specifically attributed to vascular causes (such as stroke history or cerebrovascular disease) rather than other types like Alzheimer's, as this affects code selection
Clinical Significance
Mild vascular dementia with agitation indicates early-stage cerebrovascular cognitive decline with agitated behavior. Even in mild dementia, agitation can cause significant challenges for caregivers and may be an early indicator of disease progression requiring proactive behavioral management strategies.
Documentation Requirements
- ✓Diagnosis of vascular dementia with cerebrovascular etiology
- ✓Severity explicitly documented as 'mild'
- ✓Documented agitation as a behavioral disturbance
- ✓Cognitive assessment supporting mild stage
- ✓Behavioral management plan for agitation
- ✓Safety assessment
- ✓Caregiver impact and support plan
Commonly Confused Codes
- •F01.A0: Vascular dementia, mild, without behavioral disturbance: use when no agitation is present
- •F01.511: Vascular dementia, unspecified severity, with agitation: use when severity is not specified
- •F01.B11: Vascular dementia, moderate, with agitation: use when severity is moderate
- •F01.A18: Vascular dementia, mild, with other behavioral disturbance: for non-agitation behavioral issues