2025 ICD-10-CM code F02.C1
Severe dementia caused by other diseases, accompanied by behavioral disturbances.
Medical necessity is established by demonstrating a causal link between the underlying physiological condition and the dementia with behavioral disturbance, along with the severity impacting the patient's functional status.
Clinicians should comprehensively document the specific behavioral disturbances, the underlying medical condition causing the dementia, and the severity of the cognitive impairment to justify the use of this code. This typically involves a detailed history, physical examination, neuropsychological testing, and potentially neuroimaging studies.
- Mental, Behavioral and Neurodevelopmental disorders (F01-F99)
- F02.C: Dementia in other diseases classified elsewhere, severe
In simple words: This code represents severe memory loss and cognitive decline due to an underlying medical condition, along with changes in behavior.
Dementia in other diseases classified elsewhere, severe, with behavioral disturbance. This code signifies severe dementia resulting from a condition other than those specifically classified for dementia (such as Alzheimer's or vascular dementia), and is characterized by notable behavioral disturbances.
Example 1: A patient with severe Huntington's disease (G10) experiences significant memory loss, difficulty with problem-solving, and displays aggressive behaviors, qualifying for the code F02.C1. G10 would be the primary diagnosis, followed by F02.C1., A patient with severe traumatic brain injury (S06.-) develops dementia with agitation and disinhibition, justifying F02.C1, with S06.- as the primary diagnosis., A patient with advanced multiple sclerosis (G35) experiences severe cognitive decline, coupled with emotional lability and apathy, meeting the criteria for F02.C1, while G35 serves as the primary diagnosis.
Documentation should include details about the behavioral disturbances (e.g., agitation, aggression, apathy), evidence of severe cognitive decline affecting daily life, diagnostic workup for the underlying condition, and exclusion of other primary dementia diagnoses.
** This code is part of a broader classification system for mental disorders due to known physiological conditions (F01-F09). This system emphasizes the importance of identifying and coding the underlying medical cause driving the cognitive and behavioral changes.
- Specialties:Neurology, Psychiatry, Geriatrics, Internal Medicine
- Place of Service:Inpatient Hospital, Outpatient Hospital, Skilled Nursing Facility, Nursing Facility,Office, Hospice