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F02.818 ICD-10-CM Code: Dementia in other diseases classified elsewhere, unspecified severity, with other behavioral disturbance

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FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Mental disorders due to known physiological conditions (F01-F09)

F02.818

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Dementia in other diseases classified elsewhere, unspecified severity, with other behavioral disturbance

Dementia resulting from another medical condition, severity unspecified, with behavioral problems other than agitation.

Buddy the Bee presenting code insight

Buddy Insight

Dementia in other diseases classified elsewhere, unspecified severity, with other behavioral disturbance represents cognitive deterioration secondary to an underlying medical condition, at the unspecified stage with behavioral disturbance other than agitation (e.

CMS-HCC V28

HCC 127

RAF 0.341

CMS-HCC V24

HCC 51

RAF 0.346

ACA/HHS

N/A

—

Not mapped

ESRD/PACE

HCC 51

RAF 0.042

RXHCC

HCC 112

Not separately weighted

Code Book Path

Official
F02.8Dementia in other diseases classified elsewhere, unspecified severity
F02.81Dementia in other diseases classified elsewhere, unspecified severity, with behavioral disturbance
F02.818Dementia in other diseases classified elsewhere, unspecified severity, with other behavioral disturbance

Inclusion Terms

Official
  • Dementia in other diseases classified elsewhere with sleep disturbance, social disinhibition, or sexual disinhibition
  • Major neurocognitive disorder in other diseases classified elsewhere with sleep disturbance, social disinhibition, or sexual disinhibition

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for F02.818 in this effective period.

Related Child Codes

Official
F02.811Dementia in other diseases classified elsewhere, unspecified severity, with agitation

Includes

Official

ICD-10-CM does not list Includes notes for F02.818 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for F02.818 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for F02.818 in this effective period.

Use Additional

Official
  • code, if applicable, to identify wandering in dementia in conditions classified elsewhere (Z91.83)

Code Also

Official

ICD-10-CM does not list Code Also instructions for F02.818 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Documentation must specify: (1) the dementia type and underlying etiology — F02 codes require a code-first relationship — the underlying condition (e.g., Parkinson disease, Huntington disease, HIV, traumatic brain injury) must be sequenced before the F02 code.
(2) Severity must be clearly stated as unspecified based on standardized assessment tools such as the Clinical Dementia Rating (CDR) scale or Mini-Mental State Examination (MMSE).
(3) Document the specific behavioral disturbance type, such as wandering, sleep-wake cycle disruption, disinhibition, or repetitive behaviors.
(4) Document the impact on activities of daily living, need for supervision, and current medication management.

MEAT Support

HCC Buddy guidance
Documentation must specify: (1) the dementia type and underlying etiology — F02 codes require a code-first relationship — the underlying condition (e.g., Parkinson disease, Huntington disease, HIV, traumatic brain injury) must be sequenced before the F02 code.
(2) Severity must be clearly stated as unspecified based on standardized assessment tools such as the Clinical Dementia Rating (CDR) scale or Mini-Mental State Examination (MMSE).
(3) Document the specific behavioral disturbance type, such as wandering, sleep-wake cycle disruption, disinhibition, or repetitive behaviors.
(4) Document the impact on activities of daily living, need for supervision, and current medication management.

Audit Caution

HCC Buddy guidance
Omitting the code-first underlying condition — F02 codes mandate that the causative disease (e.g., G30 for Alzheimer, G20 for Parkinson, B20 for HIV) is sequenced before the dementia code. Accepting unspecified severity without querying the provider — dementia severity directly affects HCC mapping and RAF weight. A simple query can yield a more specific code with higher risk adjustment value. Failing to document the specific behavioral disturbance type — 'other behavioral disturbance' should be supported by documentation of the actual behavior (wandering, sleep disturbance, etc.) rather than used as a catch-all. Misassigning dementia severity — the unspecified severity level maps to V28 HCC 127 with RAF 0.
Incorrect staging can result in either over- or under-reporting risk, affecting both compliance and reimbursement accuracy. Overlooking the ICD-10-CM guideline requiring that dementia behavioral codes be used as combination codes — do not assign both a dementia code and a separate code for the behavioral/psychiatric manifestation when the combination code exists.

Common Mistakes

HCC Buddy guidance
F02.A0-F02.A4: Dementia in other diseases, mild — use when severity is explicitly documented as mild
F02.B0-F02.B4: Dementia in other diseases, moderate — use when severity is documented as moderate
F02.C0-F02.C4: Dementia in other diseases, severe — use when severity is documented as severe
F01 codes: Vascular dementia — use when dementia is caused by cerebrovascular disease specifically

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 F02.818 an HCC code?

Yes. F02.818 (Dementia in other diseases classified elsewhere, unspecified severity, with other behavioral disturbance) maps to Dementia, Mild or Unspecified under the CMS-HCC V28 risk adjustment model (and Dementia With Complications under V24), with a community non-dual aged RAF of 0.341. It is billable for payment year 2026.

Coder answer: F02.818 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
F02.818
Description
Dementia in other diseases classified elsewhere, unspecified severity, with other behavioral disturbance
HCC (V28)
HCC 127 — Dementia, Mild or Unspecified
RAF
0.341
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 127, Dementia, Mild or Unspecified
0.341
V24HCC 51, Dementia With Complications
0.346
ESRDHCC 51, Dementia With Complications
0.042
RxHCCHCC 112, Dementia and Other Specified Brain Disorders
Not separately weighted

Each model's RAF is its CMS base weight for that model's standard population, so 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 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.

Work F02.818 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for F02.818

For F02.818 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 F02.818 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

F02.818 is the ICD-10-CM diagnosis code for dementia in other diseases classified elsewhere, unspecified severity, with other behavioral disturbance. Dementia resulting from another medical condition, severity unspecified, with behavioral problems other than agitation. F02.818 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, F02.818 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, F02.818 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.

Identify and code the underlying disease first. Because F02.818 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 F02.818 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Identify and code the underlying disease first
  • •Clearly document the specific behavioral disturbance that is not agitation, psychotic, mood, or anxiety-related

Clinical Significance

Dementia in other diseases classified elsewhere, unspecified severity, with other behavioral disturbance represents cognitive deterioration secondary to an underlying medical condition, at the unspecified stage with behavioral disturbance other than agitation (e.g., wandering, sleep disturbance, hoarding, inappropriate social behavior). This code captures the dementia manifestation of systemic or neurological diseases such as Parkinson disease, Lewy body disease, Huntington disease, HIV, or prion disease. Proper identification of both the underlying etiology and the dementia severity with associated symptoms is critical for treatment planning and risk stratification.

Documentation Requirements

  • ✓Documentation must specify: (1) the dementia type and underlying etiology — F02 codes require a code-first relationship — the underlying condition (e.g., Parkinson disease, Huntington disease, HIV, traumatic brain injury) must be sequenced before the F02 code.
  • ✓(2) Severity must be clearly stated as unspecified based on standardized assessment tools such as the Clinical Dementia Rating (CDR) scale or Mini-Mental State Examination (MMSE).
  • ✓(3) Document the specific behavioral disturbance type, such as wandering, sleep-wake cycle disruption, disinhibition, or repetitive behaviors.
  • ✓(4) Document the impact on activities of daily living, need for supervision, and current medication management.

Use Additional Code

  • code, if applicable, to identify wandering in dementia in conditions classified elsewhere (Z91.83)

Commonly Confused Codes

  • •F02.A0-F02.A4: Dementia in other diseases, mild: use when severity is explicitly documented as mild
  • •F02.B0-F02.B4: Dementia in other diseases, moderate: use when severity is documented as moderate
  • •F02.C0-F02.C4: Dementia in other diseases, severe: use when severity is documented as severe
  • •F01 codes: Vascular dementia: use when dementia is caused by cerebrovascular disease specifically
  • •F03 codes: Unspecified dementia: use only when both etiology and classification are unknown

Child Codes

F02.811Dementia in other diseases classified elsewhere, unspecified severity, with agitation
HCC 127
F02.818Dementia in other diseases classified elsewhere, unspecified severity, with other behavioral disturbance
HCC 127

Code Hierarchy

└F02Dementia in other diseases classified elsewhere└F02.8Dementia in other diseases classified elsewhere, unspecified severity└F02.81Dementia in other diseases classified elsewhere, unspecified severity, with behavioral disturbance└F02.818Dementia in other diseases classified elsewhere, unspecified severity, with other behavioral disturbance
└F02.818Dementia in other diseases classified elsewhere, unspecified severity, with other behavioral disturbance

F02.818 code history

Code setChange
FY2023 (effective Oct 1, 2022)Added to the code set

Source: official CMS ICD-10-CM order and addenda files, FY2016 through FY2027.

Because F02.818 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

F02.818 maps to CMS-HCC V28 category 127, Dementia, Mild or Unspecified. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. Because F02.818 carries a payment HCC, you can see what it adds to a RAF score and check the documentation the chart needs before it is submitted.

More on F02.818

Related condition guides

Referenced in blog posts

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