F03 ICD-10-CM Code: Unspecified dementia
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Mental disorders due to known physiological conditions (F01-F09)
F03
Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidanceUnspecified dementia
Unspecified dementia
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
Code Trumping
Basket needed
Code Book Path
Inclusion Terms
Official- Major neurocognitive disorder NOS
- Presenile dementia NOS
- Presenile psychosis NOS
- Primary degenerative dementia NOS
- Senile dementia NOS
Excludes 2
Official- dementia with delirium or acute confusional state (F05)
- mild memory disturbance due to known physiological condition (F06.8)
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for F03 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for F03 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for F03 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for F03 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for F03 in this effective period.
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.
What This Code Means
F03 is the ICD-10-CM diagnosis code for unspecified dementia. F03 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).
Header codes like F03 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at F03's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for F03 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.