F01.A4
BillableVascular dementia, mild, with anxiety
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F01.A4 an HCC code?
Yes. F01.A4 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.A4
For F01.A4to 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.A4 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F01.A4 is the ICD-10-CM diagnosis code for vascular dementia, mild, with anxiety. Early-stage dementia caused by reduced blood flow to the brain with anxiety symptoms. F01.A4 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.A4 maps to Dementia, Mild or Unspecified (HCC 127) with a community, non-dual, aged base RAF weight of 0.464. F01.A4 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.
Confirm that anxiety is a documented feature of the vascular dementia presentation. Because F01.A4 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.A4 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Confirm that anxiety is a documented feature of the vascular dementia presentation
- •This code should not be used if anxiety is secondary to another condition rather than part of the dementia syndrome
Clinical Significance
Mild vascular dementia with anxiety captures early-stage cerebrovascular cognitive decline with significant anxiety symptoms. Anxiety in early dementia often reflects the patient's awareness of cognitive decline and fear of further deterioration, making it both a clinical symptom and a marker of preserved insight.
Documentation Requirements
- ✓Diagnosis of vascular dementia with cerebrovascular etiology
- ✓Severity explicitly documented as 'mild'
- ✓Documented anxiety symptoms (excessive worry, fear, restlessness, panic symptoms)
- ✓Cognitive assessment supporting mild stage
- ✓Anxiety screening or clinical assessment
- ✓Treatment plan for anxiety management
Commonly Confused Codes
- •F01.A0 — Vascular dementia, mild, without behavioral disturbance: use when no anxiety is present
- •F01.54 — Vascular dementia, unspecified severity, with anxiety: when severity is not specified
- •F01.A3 — Vascular dementia, mild, with mood disturbance: for depression rather than anxiety
- •F41.1 — Generalized anxiety disorder: standalone anxiety not in dementia context