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v1.0.0
ICD-10 Guide
ICD-10 CodesF03.94

F03.94

Billable

Unspecified dementia, unspecified severity, with anxiety

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

Code Description

ICD-10 F03.94 is a billable code used to indicate a diagnosis of unspecified dementia, unspecified severity, with anxiety.

Key Diagnostic Point:

F03.94 refers to 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 dementia is not clearly defined, but the patient exhibits symptoms of anxiety, which can complicate the clinical picture. Dementia is a syndrome that affects memory, thinking, and social abilities severely enough to interfere with daily functioning. The presence of anxiety can exacerbate cognitive symptoms, leading to increased confusion, agitation, and difficulty in communication. Cognitive assessments, such as the Mini-Mental State Examination (MMSE) or Montreal Cognitive Assessment (MoCA), may be utilized to evaluate cognitive function. Behavioral symptoms may include mood swings, irritability, and withdrawal from social interactions. Caregiver support is crucial, as caregivers often face significant emotional and physical challenges in managing the care of individuals with dementia. Education and resources for caregivers can help mitigate stress and improve the quality of care provided.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Lack of specificity regarding the type of dementia
  • Variability in severity assessment
  • Comorbid anxiety complicating diagnosis and treatment
  • Need for comprehensive documentation to support coding

Audit Risk Factors

  • Insufficient documentation of cognitive assessments
  • Lack of clarity on the severity of dementia
  • Inadequate documentation of anxiety symptoms
  • Failure to document caregiver involvement

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed cognitive assessments, history of present illness, and mental status examinations.

Common Clinical Scenarios

Diagnosis of dementia in patients presenting with memory loss and anxiety symptoms.

Billing Considerations

Neurologists should ensure comprehensive documentation of cognitive decline and associated behavioral symptoms.

Psychiatry

Documentation Requirements

Mental health evaluations, treatment plans addressing anxiety, and documentation of cognitive impairments.

Common Clinical Scenarios

Management of anxiety in patients with dementia.

Billing Considerations

Psychiatrists must differentiate between anxiety as a primary condition versus a symptom of dementia.

Coding Guidelines

Inclusion Criteria

Use F03.94 When
  • According to ICD
  • 10 coding guidelines, F03
  • 94 should be used when the type and severity of dementia are not specified, but anxiety is present
  • Coders should ensure that documentation supports the diagnosis and includes details about cognitive assessments and behavioral symptoms

Exclusion Criteria

Do NOT use F03.94 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 reports are available.

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, improving the ability to capture the complexity of dementia presentations, including comorbid anxiety.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of dementia-related conditions, improving the ability to capture the complexity of dementia presentations, including comorbid anxiety.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of dementia-related conditions, improving the ability to capture the complexity of dementia presentations, including comorbid anxiety.

Resources

Clinical References

  • •
    Alzheimer's Association
  • •
    National Institute on Aging

Coding & Billing References

  • •
    Alzheimer's Association
  • •
    National Institute on Aging

Frequently Asked Questions

What should be documented to support the use of F03.94?

Documentation should include cognitive assessment results, details about the patient's anxiety symptoms, and any relevant history that supports the diagnosis of unspecified dementia.

Can F03.94 be used if the type of dementia is later identified?

No, once a specific type of dementia is identified, the appropriate code should be used instead of F03.94.