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v1.0.0
ICD-10 Guide
ICD-10 CodesF03.90

F03.90

Billable

Unspecified dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety

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

Code Description

ICD-10 F03.90 is a billable code used to indicate a diagnosis of unspecified dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety.

Key Diagnostic Point:

F03.90 refers to unspecified dementia that does not exhibit behavioral, psychotic, mood, or anxiety disturbances. This diagnosis is often used when a patient presents with cognitive decline that does not fit neatly into specific dementia categories such as Alzheimer's disease or vascular dementia. Clinically, patients may experience memory loss, difficulty with problem-solving, and challenges in performing familiar tasks. The absence of behavioral disturbances suggests that the patient may not exhibit aggression, agitation, or significant mood changes, which can complicate the clinical picture. This code is often utilized when the severity of dementia is not clearly defined, making it essential for healthcare providers to conduct thorough cognitive assessments to evaluate the patient's functional abilities and cognitive status. Caregiver support is crucial, as caregivers often face challenges in managing daily activities and ensuring safety for individuals with dementia, even in the absence of behavioral disturbances.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Lack of specificity in the diagnosis can lead to misinterpretation.
  • Differentiating between types of dementia requires comprehensive cognitive assessments.
  • Documentation must clearly indicate the absence of behavioral disturbances.
  • Variability in severity assessment can complicate coding.

Audit Risk Factors

  • Inadequate documentation of cognitive assessments.
  • Failure to specify the absence of behavioral disturbances.
  • Misclassification of dementia type.
  • Inconsistent severity assessments.

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed cognitive assessments and neurological evaluations.

Common Clinical Scenarios

Patients presenting with memory loss and cognitive decline without behavioral issues.

Billing Considerations

Neurologists must ensure that all cognitive deficits are documented to support the diagnosis.

Geriatrics

Documentation Requirements

Comprehensive assessments of functional status and caregiver support needs.

Common Clinical Scenarios

Older adults with gradual cognitive decline and no significant behavioral changes.

Billing Considerations

Geriatricians should focus on the impact of dementia on daily living activities.

Coding Guidelines

Inclusion Criteria

Use F03.90 When
  • According to ICD
  • 10 guidelines, F03
  • 90 should be used when dementia is diagnosed but does not fit into a more specific category
  • It is essential to document the absence of behavioral, psychotic, mood, and anxiety disturbances to justify the use of this code

Exclusion Criteria

Do NOT use F03.90 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 specific tests performed and the results.

Specialty Considerations

Neuropsychologists should ensure that the testing aligns with the diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more detailed coding of dementia types, but it has also increased the complexity of coding unspecified dementia due to the need for thorough documentation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more detailed coding of dementia types, but it has also increased the complexity of coding unspecified dementia due to the need for thorough documentation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more detailed coding of dementia types, but it has also increased the complexity of coding unspecified dementia due to the need for thorough documentation.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

When should I use F03.90?

Use F03.90 when a patient presents with cognitive decline that does not fit into a specific dementia category and there are no behavioral disturbances.

What documentation is required for F03.90?

Documentation must include cognitive assessment results, the absence of behavioral disturbances, and any relevant functional status information.