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v1.0.0
ICD-10 Guide
ICD-10 CodesF03.911

F03.911

Billable

Unspecified dementia, unspecified severity, with agitation

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 F03.911 is a billable code used to indicate a diagnosis of unspecified dementia, unspecified severity, with agitation.

Key Diagnostic Point:

F03.911 refers to a diagnosis of unspecified dementia characterized by cognitive decline that is not attributed to a specific type of dementia, such as Alzheimer's disease or vascular dementia. This code is used when the severity of the dementia is not clearly defined, but the patient exhibits agitation, which can manifest as restlessness, irritability, or aggressive behavior. Agitation in dementia patients can complicate care and may require specific interventions. Cognitive assessments, such as the Mini-Mental State Examination (MMSE) or the Montreal Cognitive Assessment (MoCA), may be utilized to evaluate the extent of cognitive impairment. Behavioral symptoms, including agitation, can significantly impact the quality of life for both patients and caregivers. Caregiver support is crucial, as caregivers often face challenges in managing behavioral symptoms and ensuring safety. This code is essential for capturing the complexity of dementia cases where specific details are not available, allowing for appropriate treatment planning and resource allocation.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Lack of specificity in dementia type and severity
  • Variability in behavioral symptoms among patients
  • Need for comprehensive documentation to support the diagnosis
  • Potential overlap with other dementia-related codes

Audit Risk Factors

  • Inadequate documentation of cognitive assessments
  • Failure to document the severity of agitation
  • Lack of clarity in distinguishing between types of dementia
  • Insufficient evidence of caregiver involvement

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed cognitive assessments, history of symptoms, and treatment plans.

Common Clinical Scenarios

Patients presenting with memory loss, confusion, and behavioral changes.

Billing Considerations

Neurologists must ensure comprehensive evaluations to differentiate between types of dementia.

Psychiatry

Documentation Requirements

Mental status examinations, behavioral assessments, and treatment response documentation.

Common Clinical Scenarios

Patients with dementia exhibiting mood disturbances or agitation.

Billing Considerations

Psychiatrists should document the impact of agitation on daily functioning and caregiver stress.

Coding Guidelines

Inclusion Criteria

Use F03.911 When
  • According to ICD
  • 10 guidelines, F03
  • 911 should be used when the type of dementia is unspecified, and the severity is not documented
  • It is important to ensure that the diagnosis is supported by clinical evidence and that other potential causes of cognitive decline are ruled out

Exclusion Criteria

Do NOT use F03.911 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

96116CPT Code

Neuropsychological testing

Clinical Scenario

Used to assess cognitive function in patients with suspected dementia.

Documentation Requirements

Document the rationale for testing and results.

Specialty Considerations

Neurologists and psychologists should ensure comprehensive assessments are performed.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more detailed coding of dementia-related conditions, enabling better tracking of patient outcomes and resource allocation. F03.911 captures cases where specific details are lacking, ensuring that patients receive appropriate care.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more detailed coding of dementia-related conditions, enabling better tracking of patient outcomes and resource allocation. F03.911 captures cases where specific details are lacking, ensuring that patients receive appropriate care.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more detailed coding of dementia-related conditions, enabling better tracking of patient outcomes and resource allocation. F03.911 captures cases where specific details are lacking, ensuring that patients receive appropriate care.

Resources

Clinical References

  • •
    Dementia Care: A Guide for Caregivers

Coding & Billing References

  • •
    Dementia Care: A Guide for Caregivers

Frequently Asked Questions

When should I use F03.911?

Use F03.911 when a patient presents with dementia symptoms but the specific type and severity are not documented, and there is evidence of agitation.