F02.82
BillableDementia in other diseases classified elsewhere, unspecified severity, with psychotic disturbance
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F02.82 an HCC code?
Yes. F02.82 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 F02.82
For F02.82 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 F02.82 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F02.82 is the ICD-10-CM diagnosis code for dementia in other diseases classified elsewhere, unspecified severity, with psychotic disturbance. This code describes dementia caused by another medical condition (not Alzheimer's or Parkinson's) where the severity level is not specified, and the patient is experiencing psychotic symptoms such as hallucinations or delusions. The psychotic disturbance is a behavioral complication of the underlying dementia. F02.82 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, F02.82 maps to Dementia, Mild or Unspecified (HCC 127) with a community, non-dual, aged base RAF weight of 0.464. F02.82 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.
Always code the underlying disease first (the condition causing the dementia), then use F02.82 as a secondary diagnosis to specify the dementia manifestation with psychotic features. Because F02.82 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 F02.82 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Always code the underlying disease first (the condition causing the dementia), then use F02.82 as a secondary diagnosis to specify the dementia manifestation with psychotic features
- •Verify documentation clearly states psychotic disturbance (hallucinations, delusions, or paranoia) rather than other behavioral symptoms; if severity is documented, use a more specific F02.8x code (F02.80, F02.81, or F02.83)
Clinical Significance
Dementia in other diseases classified elsewhere, unspecified severity, with psychotic disturbance represents cognitive deterioration secondary to an underlying medical condition, at the unspecified stage with psychotic features such as hallucinations or delusions. 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 type of psychotic features present — visual hallucinations, auditory hallucinations, paranoid delusions, or misidentification syndromes — and confirm they are attributable to the dementia rather than a primary psychiatric disorder.
- ✓(4) Document the impact on activities of daily living, need for supervision, and current medication management.
Commonly Confused Codes
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