2026 ICD-10-CM Diagnosis Code F02.A3Dementia in other diseases classified elsewhere, mild, with mood disturbance
ICD-10-CM Codes›F01–F99›F01-F09›F02
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Risk Adjusts — HCC 127
- Chronic Condition
F02.A3 is a billable ICD-10-CM diagnosis code for dementia in other diseases classified elsewhere, mild, with mood disturbance. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 884. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 20 closely related codes. The code is a manifestation code that cannot be reported as the principal diagnosis. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Neurocognitive disorders.
For Medicare Advantage risk adjustment, F02.A3 maps to CMS-HCC Category 127 (Dementia, Mild or Unspecified) under the V28 model, adding a risk factor of about 0.341 for a community, non-dual, aged beneficiary in payment year 2026.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for F02.A3.
Medicare Risk Adjustment (HCC)Billing
F02.A3 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2026.
Source: CMS Payment Year 2026 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Inclusion Terms
- Dementia in other diseases classified elsewhere, mild, with mood disturbance such as depression, apathy, or anhedonia
- Major neurocognitive disorder in other diseases classified elsewhere, mild, with mood disturbance such as depression, apathy, or anhedonia
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Dementia
Dementia is a loss of mental functions that is severe enough to affect your daily life and activities. These functions include:
The full article covers:
- What is dementia?
- What are the types of dementia?
- Who is at risk for dementia?
- What are the symptoms of dementia?
- How is dementia diagnosed?
- What are the treatments for dementia?
- Can dementia be prevented?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Code History & ChangesHistory
Replacement F02.A3 replaces the following previously assigned code(s):
- F02.81 - Dem in other dis classd elswhr, unsp sev, with beh distrb
- F02.81 - Dementia in oth diseases classd elswhr w behavioral disturb
Questions About F02.A3Overview
Is F02.A3 (Dementia in other diseases classified elsewhere, mild) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report dementia in other diseases classified elsewhere, mild, with mood disturbance on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does F02.A3 group to?
On inpatient claims, dementia in other diseases classified elsewhere, mild, with mood disturbance maps to MS-DRG 884 (organic Disturbances and Intellectual Disability), which carries a relative weight of 1.6089. Higher weights mean higher Medicare reimbursement.
Is F02.A3 a CC or MCC?
CMS lists F02.A3 as a CC (complication or comorbidity) for FY 2026. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 20 closely related codes in its exclusion list.
Can F02.A3 be a principal diagnosis?
No. This is a manifestation code: dementia in other diseases classified elsewhere, mild, with mood disturbance describes the manifestation of an underlying disease rather than the disease itself, so the underlying condition is sequenced first.
What HCC is F02.A3?
F02.A3 (dementia in other diseases classified elsewhere, mild, with mood disturbance) maps to CMS-HCC Category 127 (Dementia, Mild or Unspecified), commonly written as HCC 127, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2026. It mapped to HCC 51 under the retired V24 model. It also maps in the ESRD (V21) and ESRD (V24) models. In the Part D prescription drug model it maps to RxHCC 112.
Does F02.A3 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, F02.A3 adds a risk adjustment factor of about 0.341 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.000 to 0.438 depending on the payment segment). A more severe related category (HCC 125 and HCC 126) supersedes it when both are reported. See the full factor table on the HCC 127 category page.
