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F02.A4 ICD-10-CM Code: Dementia in other diseases classified elsewhere, mild, with anxiety

F02.A4 maps to CMS-HCC V28 127 (RAF 0.341). Documentation must support MEAT. MEAT criteria · RAF calculator · HCC coding software

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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.A4

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

Dementia in other diseases classified elsewhere, mild, with anxiety

Early-stage dementia caused by another disease with excessive worry, nervousness, or anxiety symptoms.

Buddy the Bee presenting code insight

Buddy Insight

Dementia in other diseases classified elsewhere, mild, with anxiety represents cognitive deterioration secondary to an underlying medical condition, at the mild stage with anxiety symptoms.

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
F02Dementia in other diseases classified elsewhere
F02.ADementia in other diseases classified elsewhere, mild
F02.A4Dementia in other diseases classified elsewhere, mild, with anxiety

Inclusion Terms

Official
  • Major neurocognitive disorder in other diseases classified elsewhere, mild, with anxiety

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for F02.A4 in this effective period.

Related Child Codes

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

Includes

Official

ICD-10-CM does not list Includes notes for F02.A4 in this effective period.

Excludes 1

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

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for F02.A4 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for F02.A4 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for F02.A4 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 mild based on standardized assessment tools such as the Clinical Dementia Rating (CDR) scale or Mini-Mental State Examination (MMSE).
(3) Document the anxiety manifestations (e.g., generalized worry, fear of being alone, sundowning-related anxiety) and confirm the anxiety is a feature of the dementia process.
(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 anxiety manifestations (e.g., generalized worry, fear of being alone, sundowning-related anxiety) and confirm the anxiety is a feature of the dementia process.
(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. Coding a separate anxiety disorder (F41) when the anxiety is a documented feature of the dementia process — the combination code already captures this. Misassigning dementia severity — the mild 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
F02.80-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

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.A4 an HCC code?

Yes. F02.A4 (Dementia in other diseases classified elsewhere, mild, with anxiety) 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.A4 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.A4
Description
Dementia in other diseases classified elsewhere, mild, with anxiety
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.A4 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for F02.A4

For F02.A4 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.A4 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

F02.A4 is the ICD-10-CM diagnosis code for dementia in other diseases classified elsewhere, mild, with anxiety. Early-stage dementia caused by another disease with excessive worry, nervousness, or anxiety symptoms. F02.A4 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.A4 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.A4 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.

Document the manifestations of anxiety (panic, worry, physical symptoms) in clinical notes. Because F02.A4 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.A4 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Document the manifestations of anxiety (panic, worry, physical symptoms) in clinical notes
  • •Verify the anxiety is related to the dementia process rather than a separate anxiety disorder

Clinical Significance

Dementia in other diseases classified elsewhere, mild, with anxiety represents cognitive deterioration secondary to an underlying medical condition, at the mild stage with anxiety symptoms. 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 anxiety manifestations (e.g., generalized worry, fear of being alone, sundowning-related anxiety) and confirm the anxiety is a feature of the dementia process.
  • ✓(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

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.A4Dementia in other diseases classified elsewhere, mild, with anxiety
└F02.A4Dementia in other diseases classified elsewhere, mild, with anxiety

F02.A4 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.A4 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.A4 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.A4 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.A4

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