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F03 ICD-10-CM Code: Unspecified dementia

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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 guidance

Unspecified dementia

Unspecified dementia

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
F0Mental disorders due to known physiological conditions (F01-F09)
F03Unspecified dementia

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

Official
F03.9Unspecified dementia, unspecified severity
F03.AUnspecified dementia, mild
F03.BUnspecified dementia, moderate
F03.CUnspecified dementia, severe

Includes

Official

ICD-10-CM does not list Includes notes for F03 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for F03 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for F03 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for F03 in this effective period.

Code Also

Official

ICD-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.

Excludes 2, Not included here, may code separately

  • dementia with delirium or acute confusional state (F05)
  • mild memory disturbance due to known physiological condition (F06.8)

Child Codes

Code Hierarchy

F03Unspecified dementia
F03Unspecified dementia

More on F03

Related condition guides

Referenced in blog posts

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