F02.A11 ICD-10-CM Code: Dementia in other diseases classified elsewhere, mild, with agitation
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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.A11
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceDementia in other diseases classified elsewhere, mild, with agitation
Memory loss and cognitive decline caused by another medical condition in its early stages, with restlessness and agitation.
Buddy Insight
Dementia in other diseases classified elsewhere, mild, with agitation represents cognitive deterioration secondary to an underlying medical condition, at the mild stage with agitation (e.
CMS-HCC V28
MappedHCC 127
RAF 0.464
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
MappedHCC 112
RAF 0.0
Code Trumping
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Code Book Path
Inclusion Terms
Official- Dementia in other diseases classified elsewhere, mild, with aberrant motor behavior such as restlessness, rocking, pacing, or exit-seeking
- Dementia in other diseases classified elsewhere, mild, with verbal or physical behaviors such as profanity, shouting, threatening, anger, aggression, combativeness, or violence
- Major neurocognitive disorder in other diseases classified elsewhere, mild, with aberrant motor behavior such as restlessness, rocking, pacing, or exit-seeking
- Major neurocognitive disorder in other diseases classified elsewhere, mild, with verbal or physical behaviors such as profanity, shouting, threatening, anger, aggression, combativeness, or violence
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for F02.A11 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for F02.A11 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for F02.A11 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for F02.A11 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for F02.A11 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for F02.A11 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is F02.A11 an HCC code?
Yes. F02.A11 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.A11
For F02.A11to 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.A11 during that encounter, not just copy-forwarded from a problem list.
What This Code Means
F02.A11 is the ICD-10-CM diagnosis code for dementia in other diseases classified elsewhere, mild, with agitation. Memory loss and cognitive decline caused by another medical condition in its early stages, with restlessness and agitation. F02.A11 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.A11 maps to Dementia, Mild or Unspecified (HCC 127) with a community, non-dual, aged base RAF weight of 0.464. F02.A11 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 (e.g., Parkinson's, Lewy body disease) before this dementia code. Because F02.A11 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.A11 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 (e.g., Parkinson's, Lewy body disease) before this dementia code
- •The 'A' indicates mild severity; ensure documentation supports this level rather than moderate or severe
Clinical Significance
Dementia in other diseases classified elsewhere, mild, with agitation represents cognitive deterioration secondary to an underlying medical condition, at the mild stage with agitation (e.g., restlessness, pacing, verbal or physical aggression). 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 mild based on standardized assessment tools such as the Clinical Dementia Rating (CDR) scale or Mini-Mental State Examination (MMSE).
- ✓(3) Document specific agitation behaviors such as pacing, verbal outbursts, combativeness, or resistance to care, including frequency and triggers.
- ✓(4) Document the impact on activities of daily living, need for supervision, and current medication management.
Commonly Confused Codes
- •F02.80-F02.84: Dementia in other diseases, unspecified severity: use only if severity is not documented
- •F02.B0-F02.B4: Dementia in other diseases, moderate: higher severity; verify cognitive assessment supports mild classification
- •G31.84: Mild cognitive impairment: distinct from mild dementia; MCI does not meet dementia diagnostic criteria
- •F03.A0-F03.A4: Unspecified dementia, mild: use only when the underlying etiology has not been identified
- •F01.A0-F01.A4: Vascular dementia, mild: use when etiology is specifically cerebrovascular disease