F03.C0

Billable

Unspecified dementia, severe, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety

HCC Category Mapping

V28HCC 125 — Dementia, Severe

0.885

RxHCCHCC 112 — Dementia and Other Specified Brain Disorders

0.000

What This Code Means

Severe dementia without any additional behavioral, psychotic, mood, or anxiety disturbances, representing the most advanced stage of cognitive decline.

Coding Tips

•This code is used only when severe dementia is present without complicating behavioral or psychiatric symptoms
•Document that the patient lacks agitation, psychosis, mood disturbance, and anxiety to justify this code

Clinical Significance

This code captures severe unspecified dementia without behavioral disturbance, representing significant cognitive impairment that affects the patient's functional status and care needs. Severe dementia carries substantial risk adjustment weight because these patients require intensive care coordination, caregiver support, and monitoring for complications. Accurate severity staging and behavioral documentation directly impact both clinical management and appropriate resource allocation.

Documentation Requirements

✓Provider documentation explicitly stating dementia severity as 'severe'
✓Cognitive assessment results (e.g., MMSE, MoCA, or SLUMS score) supporting the stated severity level
✓Functional status assessment documenting impact on activities of daily living
✓Statement that underlying etiology is unknown or unspecified (if a known cause exists, use a more specific dementia code)
✓Documentation of anxiety symptoms as a manifestation of the dementia process, not a separate anxiety disorder

Commonly Confused Codes

F03.B4 — Unspecified dementia, moderate, with anxiety; lower severity — verify cognitive testing supports severe staging F01.C0 through F01.C4 — Vascular dementia, severe; use when documentation attributes dementia to cerebrovascular disease F02.C0 through F02.C4 — Dementia in other diseases classified elsewhere, severe; use when a known underlying condition causes the dementia (code underlying condition first)G30.9 with F02 codes — Alzheimer disease with dementia; use F02 codes when Alzheimer is the documented cause

Code Hierarchy

└F03Unspecified dementia └F03.CUnspecified dementia, severe └F03.C0Unspecified dementia, severe, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety

└F03.C0Unspecified dementia, severe, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety