F01.B11

Billable

Vascular dementia, moderate, with agitation

HCC Category Mapping

V28HCC 126 — Dementia, Moderate

0.550

RxHCCHCC 112 — Dementia and Other Specified Brain Disorders

0.000

What This Code Means

Mid-stage dementia caused by reduced blood flow to the brain with agitation or restlessness.

Coding Tips

•Agitation is a specific behavioral disturbance; document observable signs such as pacing, verbal outbursts, or physical aggression
•This code is more specific than F01.B18 and should be used when agitation is the primary behavioral concern

Clinical Significance

Moderate vascular dementia with agitation represents intermediate-stage cerebrovascular cognitive decline complicated by agitated behavior. Agitation at the moderate stage often requires pharmacologic intervention and increases the risk of institutionalization, falls, and caregiver burnout.

Documentation Requirements

✓Diagnosis of vascular dementia with cerebrovascular etiology
✓Severity explicitly documented as 'moderate'
✓Documented agitation (physical restlessness, verbal aggression, combative behavior)
✓Cognitive testing supporting moderate impairment
✓Functional assessment documenting assistance needs
✓Behavioral management plan including non-pharmacologic and pharmacologic interventions
✓Safety assessment for patient and caregivers

Commonly Confused Codes

F01.B0 — Vascular dementia, moderate, without behavioral disturbance: use when no agitation present F01.A11 — Vascular dementia, mild, with agitation: use when severity is mild F01.511 — Vascular dementia, unspecified severity, with agitation: when severity is unspecified F01.B18 — Vascular dementia, moderate, with other behavioral disturbance: for non-agitation behaviors

Code Hierarchy

└F01Vascular dementia └F01.BVascular dementia, moderate └F01.B1Vascular dementia, moderate, with behavioral disturbance └F01.B11Vascular dementia, moderate, with agitation

└F01.B11Vascular dementia, moderate, with agitation