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2025 ICD-10-CM code F03.91

Unspecified dementia with behavioral disturbance. This diagnosis is used when the type of dementia is not specified, but the patient exhibits behavioral disturbances.

This code should not be used if the specific type and severity of dementia can be documented.Code any associated behavioral disturbances separately using appropriate Z codes if needed for additional specificity.

Medical necessity for this code is established by the presence of both cognitive decline and behavioral disturbances impacting the patient's daily functioning.Further investigation to determine the underlying cause of dementia is necessary for appropriate management.

In simple words: This code indicates a general form of dementia where the exact type and severity aren't known, but the person is experiencing changes in their behavior.

Unspecified dementia, unspecified severity, with behavioral disturbance. This code signifies a diagnosis of dementia where the specific type (e.g., Alzheimer's, vascular) and severity (mild, moderate, severe) are not documented, but the patient presents with notable behavioral disturbances.These disturbances can manifest as agitation, aggression, anxiety, mood swings, and other behavioral changes.

Example 1: A 75-year-old patient presents with memory loss, confusion, and increasing agitation. The physician notes behavioral disturbances, including verbal aggression and restlessness, but further evaluation is needed to determine the specific type and severity of dementia., An 82-year-old patient with a history of cognitive decline exhibits wandering, paranoia, and urinary incontinence.The physician diagnoses dementia with behavioral disturbance, but without specifying the type or severity, pending further diagnostic tests., A 68-year-old individual displays significant personality changes, including increased irritability and social withdrawal, along with memory impairment. The physician uses this code to document dementia with behavioral disturbance while awaiting results of tests to identify the underlying cause and severity of the dementia.

Documentation should include:Detailed description of the behavioral disturbances.Evidence of cognitive impairment.Results of any cognitive assessments performed.Information regarding the patient's ability to perform activities of daily living.

** Prior to October 1, 2022, this code was used for unspecified dementia of unspecified severity with behavioral disturbance.Now there are more granular codes available in the ICD-10-CM to better specify the dementia type with associated behaviors, with a greater emphasis on accurately reflecting severity.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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