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v1.0.0
ICD-10 Guide
ICD-10 CodesF03.92

F03.92

Billable

Unspecified dementia, unspecified severity, with psychotic disturbance

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

Code Description

ICD-10 F03.92 is a billable code used to indicate a diagnosis of unspecified dementia, unspecified severity, with psychotic disturbance.

Key Diagnostic Point:

F03.92 refers to a diagnosis of unspecified dementia characterized by cognitive decline that significantly interferes with daily functioning, accompanied by psychotic disturbances such as hallucinations or delusions. This code is used when the specific type of dementia (e.g., Alzheimer's disease, vascular dementia) is not clearly defined, and the severity of cognitive impairment is not specified. Patients may exhibit a range of cognitive deficits, including memory loss, impaired reasoning, and difficulties with language and problem-solving. The presence of psychotic disturbances complicates the clinical picture, as these symptoms can lead to increased caregiver burden and necessitate a tailored approach to management. Treatment often involves a combination of pharmacological interventions to address psychotic symptoms and non-pharmacological strategies to support cognitive function and enhance quality of life. Caregiver support is crucial, as caregivers may experience significant stress and require resources to manage the complexities of caring for individuals with dementia and psychosis.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Lack of specificity regarding the type of dementia
  • Variability in severity assessment
  • Presence of psychotic symptoms complicating diagnosis
  • Need for comprehensive documentation to support coding

Audit Risk Factors

  • Inadequate documentation of cognitive assessment results
  • Failure to document the presence of psychotic symptoms
  • Lack of clarity on the severity of dementia
  • Inconsistent coding practices among providers

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

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

Common Clinical Scenarios

Diagnosis of dementia in older adults, management of psychotic symptoms in dementia.

Billing Considerations

Neurologists should ensure comprehensive evaluations to differentiate between types of dementia and document any psychotic features.

Psychiatry

Documentation Requirements

Mental status examinations, history of psychiatric symptoms, and treatment response.

Common Clinical Scenarios

Management of behavioral disturbances in dementia patients, medication management for psychotic symptoms.

Billing Considerations

Psychiatrists must document the impact of psychotic symptoms on the patient's overall functioning and quality of life.

Coding Guidelines

Inclusion Criteria

Use F03.92 When
  • According to ICD
  • 10 guidelines, F03
  • 92 should be used when the type and severity of dementia are not specified, but psychotic disturbances are present
  • Coders should ensure that documentation supports the diagnosis and reflects the patient's clinical status

Exclusion Criteria

Do NOT use F03.92 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

90791CPT Code

Psychiatric diagnostic evaluation

Clinical Scenario

Used when evaluating a patient with dementia and psychotic symptoms.

Documentation Requirements

Comprehensive history and mental status examination.

Specialty Considerations

Psychiatrists should document the rationale for the evaluation and any findings related to dementia.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of dementia-related conditions, including the ability to capture the presence of psychotic disturbances. This specificity aids in better understanding patient populations and tailoring treatment approaches.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of dementia-related conditions, including the ability to capture the presence of psychotic disturbances. This specificity aids in better understanding patient populations and tailoring treatment approaches.

Reimbursement & Billing Impact

impact on daily functioning. Providers should ensure that all relevant assessments and treatment plans are documented to support claims.

Resources

Clinical References

  • •
    Dementia Care: A Guide for Caregivers

Coding & Billing References

  • •
    Dementia Care: A Guide for Caregivers

Frequently Asked Questions

What should I document to support the use of F03.92?

Document the patient's cognitive assessments, the presence of psychotic symptoms, and how these affect daily functioning and care needs.