2025 ICD-10-CM code F02
(Active) Effective Date: N/A Revision Date: N/A Mental disorder - Mental disorders due to known physiological conditions Chapter V: Mental and behavioural disorders Feed
Dementia in other diseases classified elsewhere.Code the underlying disease first.
Modifiers may apply depending on the circumstances of the encounter. Consult the appropriate coding guidelines and payer specific rules.
Medical necessity is established by the presence of cognitive impairment significantly impacting daily functioning, attributable to a documented underlying medical condition. The documentation must support a clear causal relationship between the underlying condition and the dementia.
The physician's responsibility includes a thorough history, physical examination, cognitive assessment, and potentially neurological and laboratory testing to identify the underlying cause of the dementia.This may involve consultations with other specialists (neurology, psychiatry) to determine the etiology and manage the symptoms. Treatment is directed toward managing the underlying condition and symptomatic relief.
- Chapter V: Mental and behavioural disorders
- F01-F09 (Mental disorders due to known physiological conditions)
In simple words: This code is for dementia caused by another medical problem.The doctor will code the main problem first, then use this code to show that the patient also has dementia as a result of that other problem.
Dementia in other diseases classified elsewhere refers to cognitive impairment (memory loss and at least one other cognitive deficit) secondary to a known physiological condition.The underlying condition must be coded first.Examples of underlying conditions include Alzheimer's disease, HIV, traumatic brain injury, and various metabolic disorders.This code is used when the dementia is a consequence of a previously coded underlying medical condition.
Example 1: A 70-year-old patient with a history of poorly controlled diabetes presents with progressive memory loss, disorientation, and difficulty with daily tasks.After extensive workup, including blood tests and brain imaging,type 2 diabetes is confirmed as the underlying cause of the dementia.Code for type 2 diabetes is listed first, followed by F02., A 65-year-old patient with a history of traumatic brain injury (TBI) from a motor vehicle accident 10 years prior presents with new onset of cognitive decline including memory impairment and difficulty with executive function.The TBI is established as the underlying cause. The code for TBI is coded first, followed by F02., A 55-year-old patient with HIV infection and a CD4 count below 200 cells/mm3 presents with progressive cognitive decline.Neuropsychological testing reveals significant impairment in multiple cognitive domains.The HIV is the underlying cause, therefore HIV code is coded first followed by F02.
Comprehensive documentation is essential, including detailed history (onset, progression, and associated symptoms), results of cognitive assessments (MMSE, MoCA), neurological examination findings, laboratory results (relevant blood tests, brain imaging), and any evidence supporting the underlying medical condition causing the dementia.
** This code is for dementia secondary to other diseases.The severity and presence of behavioral disturbances should be specified with additional codes where appropriate, and are not inherently part of the F02 code.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Neurology, Psychiatry, Geriatric Medicine
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital, Skilled Nursing Facility, Other Place of Service