F01.A3
BillableVascular dementia, mild, with mood disturbance
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F01.A3 an HCC code?
Yes. F01.A3 maps to Dementia, Mild or Unspecified under the CMS-HCC V28 risk adjustment model (and Dementia With Complications under V24).
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.A3
For F01.A3to 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.A3 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F01.A3 is the ICD-10-CM diagnosis code for vascular dementia, mild, with mood disturbance. This code describes a type of dementia caused by reduced blood flow to the brain that is in its early stages and accompanied by mood changes such as depression or anxiety. The patient has mild cognitive decline but can still perform most daily activities with some difficulty. F01.A3 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.A3 maps to Dementia, Mild or Unspecified (HCC 127) with a community, non-dual, aged base RAF weight of 0.341. Under the older CMS-HCC V24 model, F01.A3 maps to Dementia With Complications (HCC 51) with a community, non-dual, aged base RAF weight of 0.346. 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.
Ensure documentation specifies both the vascular cause of dementia and the presence of mood disturbance to justify this combination code. Because F01.A3 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.A3 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 vascular cause of dementia and the presence of mood disturbance to justify this combination code
- •Do not use this code if the mood disturbance is severe enough to warrant a separate mood disorder diagnosis; verify the severity level matches 'mild' dementia classification
Clinical Significance
Mild vascular dementia with mood disturbance captures early-stage vascular cognitive decline accompanied by depression, apathy, or emotional dysregulation. Vascular depression is a recognized entity that may precede or accompany vascular dementia, and treating the mood disturbance can improve cognitive function and quality of life.
Documentation Requirements
- ✓Diagnosis of vascular dementia with cerebrovascular etiology
- ✓Severity explicitly documented as 'mild'
- ✓Specific mood disturbance documented (depression, apathy, emotional lability)
- ✓Cognitive assessment supporting mild stage
- ✓Mood assessment (PHQ-9, GDS, or clinical documentation)
- ✓Treatment plan for mood disturbance (antidepressant, psychosocial support)
Commonly Confused Codes
- •F01.A0 — Vascular dementia, mild, without behavioral disturbance: use when no mood disturbance present
- •F01.53 — Vascular dementia, unspecified severity, with mood disturbance: when severity not specified
- •F01.A4 — Vascular dementia, mild, with anxiety: for anxiety rather than mood disturbance
- •F32.9 — Major depressive disorder, single episode, unspecified: standalone depression, not dementia-related