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F02.A3 ICD-10-CM Code: Dementia in other diseases classified elsewhere, mild, with mood disturbance

F02.A3 maps to CMS-HCC V28 127. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC Buddy coding tools

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Code lookupF02.A3

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

F02.A3

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

Dementia in other diseases classified elsewhere, mild, with mood disturbance

Early-stage dementia from another medical condition with depression, mania, or other mood disturbances.

Buddy the Bee presenting code insight

Buddy Insight

Dementia in other diseases classified elsewhere, mild, with mood disturbance represents cognitive deterioration secondary to an underlying medical condition, at the mild stage with mood disturbance (e.

OverviewRisk ModelsCode BookDocumentationAuditNotesEdition comparison

CMS-HCC V28

HCC 127

Coefficient HCC 127: 0.341 (Community Non-Dual Aged (CNA))

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

N/A

—

Not mapped

ESRD/PACE

HCC 51

Code-level coefficient reference

RXHCC

HCC 112

Code-level coefficient reference

Code Book Path

Official
F02Dementia in other diseases classified elsewhereF02.ADementia in other diseases classified elsewhere, mildF02.A3Dementia in other diseases classified elsewhere, mild, with mood disturbance

Inclusion Terms

Official
  • Dementia in other diseases classified elsewhere, mild, with mood disturbance such as depression, apathy, or anhedonia
  • Major neurocognitive disorder in other diseases classified elsewhere, mild, with mood disturbance such as depression, apathy, or anhedonia

Excludes 2

Official
  • symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99)Inherited from F01-F99, F02
  • dementia in alcohol and psychoactive substance disorders (F10-F19, with .17, .27, .97)Inherited from F01-F99, F02
  • vascular dementia (F01.5-, F01.A-, F01.B-, F01.C-)Inherited from F01-F99, F02

Related Codes

Official
F02.A0Dementia in other diseases classified elsewhere, mild, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxietyF02.A1Dementia in other diseases classified elsewhere, mild, with behavioral disturbanceF02.A2Dementia in other diseases classified elsewhere, mild, with psychotic disturbanceF02.A4Dementia in other diseases classified elsewhere, mild, with anxiety

Includes

Official
  • disorders of psychological developmentInherited from F01-F99, F02
  • Major neurocognitive disorder in other diseases classified elsewhereInherited from F01-F99, F02

Excludes 1

Official
  • mild neurocognitive disorder due to known physiological condition with or without behavioral disturbance (F06.7-)Inherited from F02, F02.A

Code First

Official
  • the underlying physiological condition, such as:Inherited from F02
  • Alzheimer's (G30.-)Inherited from F02
  • cerebral lipidosis (E75.4)Inherited from F02
  • Creutzfeldt-Jakob disease (A81.0-)Inherited from F02
  • epilepsy and recurrent seizures (G40.-)Inherited from F02
  • frontotemporal dementia (G31.09)Inherited from F02
  • hepatolenticular degeneration (E83.01)Inherited from F02
  • human immunodeficiency virus [HIV] disease (B20)Inherited from F02
  • Huntington's disease (G10)Inherited from F02
  • hypercalcemia (E83.52)Inherited from F02
  • hypothyroidism, acquired (E00-E03.-)Inherited from F02
  • intoxications (T36-T65)Inherited from F02
  • Jakob-Creutzfeldt disease (A81.0-)Inherited from F02
  • multiple sclerosis (G35-)Inherited from F02
  • neurocognitive disorder with Lewy bodies (G31.83)Inherited from F02
  • neurosyphilis (A52.17)Inherited from F02
  • niacin deficiency [pellagra] (E52)Inherited from F02
  • other frontotemporal neurocognitive disorder (G31.90)Inherited from F02
  • Parkinson's disease (G20.-)Inherited from F02
  • Pick's disease (G31.01)Inherited from F02
  • polyarteritis nodosa (M30.0)Inherited from F02
  • prion disease (A81.9)Inherited from F02
  • systemic lupus erythematosus (M32.-)Inherited from F02
  • traumatic brain injury (S06.-)Inherited from F02
  • trypanosomiasis (B56.-, B57.-)Inherited from F02
  • vitamin B deficiency (E53.8)Inherited from F02

Use Additional

Official

No Use Additional Code instructions are included in this display for F02.A3. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for F02.A3. Check the code and parent instructions in the Code Book.

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 mild based on standardized assessment tools such as the Clinical Dementia Rating (CDR) scale or Mini-Mental State Examination (MMSE).
(3) Document the nature of the mood disturbance — depression, apathy, emotional lability, or irritability — and distinguish it from a primary mood disorder unrelated to the dementia.
(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 mild based on standardized assessment tools such as the Clinical Dementia Rating (CDR) scale or Mini-Mental State Examination (MMSE).
(3) Document the nature of the mood disturbance — depression, apathy, emotional lability, or irritability — and distinguish it from a primary mood disorder unrelated to the dementia.
(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. Separately coding depression (F32/F33) or other mood disorders when the mood disturbance is a direct feature of the dementia — the combination code is sufficient unless a distinct, co-occurring primary mood disorder is also documented.
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.

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.A3 an HCC code?

Yes. F02.A3 (Dementia in other diseases classified elsewhere, mild, with mood disturbance) maps to HCC 127, Dementia, Mild or Unspecified under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.341. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: F02.A3 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.A3
Description
Dementia in other diseases classified elsewhere, mild, with mood disturbance
HCC (V28)
HCC 127 — Dementia, Mild or Unspecified
RAF reference coefficient
0.341
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 127, Dementia, Mild or Unspecified
0.341
ESRDHCC 51, Dementia With Complications
Not separately weighted
RxHCCHCC 112, Dementia, Except Alzheimer's Disease
Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. 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 context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work F02.A3 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for F02.A3

For F02.A3, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

  • 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

Coder workflow notes

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What This Code Means

F02.A3 is the ICD-10-CM diagnosis code for dementia in other diseases classified elsewhere, mild, with mood disturbance. Early-stage dementia from another medical condition with depression, mania, or other mood disturbances. F02.A3 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.A3 maps to Dementia, Mild or Unspecified (HCC 127) with a source-labeled community, non-dual, aged reference coefficient of 0.341. No V24 mapping is shown for F02.A3; use the applicable model and payment year when reviewing the V28 mapping. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

Clarify whether mood disturbance is a direct result of the dementia or a separate condition. For F02.A3, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. 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, source-labeled coefficient references, and MEAT documentation criteria for F02.A3 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Clarify whether mood disturbance is a direct result of the dementia or a separate condition
  • •Consider if additional mood disorder codes are needed based on severity and treatment

Clinical Significance

Dementia in other diseases classified elsewhere, mild, with mood disturbance represents cognitive deterioration secondary to an underlying medical condition, at the mild stage with mood disturbance (e.g., depression, apathy, irritability). 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 the nature of the mood disturbance — depression, apathy, emotional lability, or irritability — and distinguish it from a primary mood disorder unrelated to the dementia.
  • ✓(4) Document the impact on activities of daily living, need for supervision, and current medication management.

Child Codes

F02.A0Dementia in other diseases classified elsewhere, mild, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
HCC 127
F02.A1Dementia in other diseases classified elsewhere, mild, with behavioral disturbance
F02.A2Dementia in other diseases classified elsewhere, mild, with psychotic disturbance
HCC 127
F02.A3Dementia in other diseases classified elsewhere, mild, with mood disturbance
HCC 127
F02.A4Dementia in other diseases classified elsewhere, mild, with anxiety
HCC 127

Code Hierarchy

└F02Dementia in other diseases classified elsewhere└F02.ADementia in other diseases classified elsewhere, mild└F02.A3Dementia in other diseases classified elsewhere, mild, with mood disturbance
└F02.A3Dementia in other diseases classified elsewhere, mild, with mood disturbance

F02.A3 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.

Also searched as

  • F02 A3
  • F02A3

For F02.A3, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

F02.A3 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. The mapping identifies a payment HCC category for F02.A3. Review its source-labeled HCC coefficient above, check the RAF Calculator with complete member context for CMS-HCC V28 PY2026, and confirm the documentation the chart needs before the code is submitted. HCC Buddy shows no RAF score unless every required source and calculation check passes.

More on F02.A3

Code family

Every F02 code with its CMS-HCC V28 statusDementia in other diseases classified elsewhere, 24 billable codes

Related condition guides

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