2027 ICD-10-CM Diagnosis Code F02.C4Dementia in other diseases classified elsewhere, severe, with anxiety

ICD-10-CM Codes›F01–F99›F01-F09›F02

ICD-10-CM F02.C4
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

F02.C4 is a billable ICD-10-CM diagnosis code for dementia in other diseases classified elsewhere, severe, with anxiety. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) 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.C4 maps to CMS-HCC Category 125 (Dementia, Severe) under the V28 model, adding a risk factor of about 0.341 for a community, non-dual, aged beneficiary in payment year 2027.

Code Identity

ICD-10-CM Code
F02.C4
Billable Status
Yes — Valid for Submission
Code Describes
Dementia in other diseases classified elsewhere, severe, with anxiety
Short Description
Dem in other diseases classd elswhr, severe, with anxiety
Parent Code
F02.C
Dementia in other diseases classified elsewhere, severe

Code Classification

ChapterF01–F99Mental and behavioural disorders
SectionF01-F09Mental disorders due to known physiological conditions
CategoryF02Dementia in other diseases classified elsewhere
This CodeF02.C4Dementia in other diseases classified elsewhere, severe, with anxiety

Code EditsBilling

Medicare Code Editor checks that affect claim validity for F02.C4.

Manifestation diagnoses
Manifestation codes describe the manifestation of an underlying disease, not the disease itself, and therefore should not be used as a principal diagnosis.

Medicare Risk Adjustment (HCC)Billing

F02.C4 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 2027.

CMS-HCC V28 Category (Payment Model)
HCC 125— Dementia, Severe
Payment HCC · PY 2027 one of 18 ICD-10-CM codes in this category
Risk Adjustment Factor (RAF) Weight
+0.341
community, non-dual, aged · ranges 0.000–0.438 across segments
Hierarchy
Supersedes HCC 126 and HCC 127
less severe related categories are not paid alongside HCC 125
Prior Model (CMS-HCC V24)
HCC 51
V24 retired V28 pays 100% of MA risk scores since PY 2026
Other CMS Models
ESRD (V21): HCC 51 · ESRD (V24): HCC 51
ESRD V21 weights: 0.097 dialysis, 0.000–0.643 functioning graft · ESRD V24 weights: 0.042 dialysis, 0.000–0.399 functioning graft
Part D (RxHCC)
RxHCC 112 — Dementia, Except Alzheimer's Disease
also risk-adjusts in the Part D prescription drug model (V08)

Source: CMS Payment Year 2027 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.

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to F02.C4: its own notes plus those printed at F02, block F01-F09, and Chapter 5. A note printed at a category, block or chapter applies to every code under it.

Includes

Further defines, or gives examples of, the content of the category.

From F02 Dementia in other diseases classified elsewhere applies to 24 codes
  • Major neurocognitive disorder in other diseases classified elsewhere
From Chapter 5 (F01-F99) Mental and behavioural disorders applies to 872 codes
  • disorders of psychological development

Applicable To

Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.

  • Major neurocognitive disorder in other diseases classified elsewhere, severe, with anxiety

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From F02 Dementia in other diseases classified elsewhere applies to 24 codes
  • mild neurocognitive disorder due to known physiological condition with or without behavioral disturbance (F06.7-)

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From F02 Dementia in other diseases classified elsewhere applies to 24 codes
From Chapter 5 (F01-F99) Mental and behavioural disorders applies to 872 codes
  • symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99)

Code First

The underlying condition named in the note is sequenced before this code.

From F02 Dementia in other diseases classified elsewhere applies to 24 codes
  • the underlying physiological condition, such as:
  • Alzheimer's (G30.-)
  • cerebral lipidosis (E75.4)
  • Creutzfeldt-Jakob disease (A81.0-)
  • epilepsy and recurrent seizures (G40.-)
  • hepatolenticular degeneration (E83.01)
  • human immunodeficiency virus [HIV] disease (B20)
  • Huntington's disease (G10)
  • hypercalcemia (E83.52)
  • hypothyroidism, acquired (E00-E03.-)
  • intoxications (T36-T65)
  • Jakob-Creutzfeldt disease (A81.0-)
  • multiple sclerosis (G35-)
  • neurocognitive disorder with Lewy bodies (G31.83)
  • neurosyphilis (A52.17)
  • niacin deficiency [pellagra] (E52)
  • other frontotemporal neurocognitive disorder (G31.09)
  • Parkinson's disease (G20.-)
  • Pick's disease (G31.01)
  • polyarteritis nodosa (M30.0)
  • prion disease (A81.9)
  • systemic lupus erythematosus (M32.-)
  • traumatic brain injury (S06.-)
  • trypanosomiasis (B56.-, B57.-)
  • vitamin B deficiency (E53.8)

Notes

General instructions on how these codes are used.

From Block F01-F09 Mental disorders due to known physiological conditions applies to 91 codes
  • This block comprises a range of mental disorders grouped together on the basis of their having in common a demonstrable etiology in cerebral disease, brain injury, or other insult leading to cerebral dysfunction. The dysfunction may be primary, as in diseases, injuries, and insults that affect the brain directly and selectively; or secondary, as in systemic diseases and disorders that attack the brain only as one of the multiple organs or systems of the body that are involved.

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name F02.C4, its category, or a range that includes it.

Applicable To 1

These notes mention F02.C4.

  • O99.34 Other mental disorders complicating pregnancy, childbirth, and the puerperium
    Conditions in F01-F09, F20-F52 and F54-F99 names F01-F09, which includes this code

Excludes1 2

These codes carry an Excludes1 note naming F02.C4: they are not reported together with it, unless the two conditions are unrelated.

  • F06.7 Mild neurocognitive disorder due to known physiological condition
    dementia (F01.-, F02.-, F03.-) names F02.-, which includes this code
  • G31.84 Mild cognitive impairment of uncertain or unknown etiology
    dementia (F01.-, F02.-, F03.-) names F02.-, which includes this code

Excludes2 3

These codes carry an Excludes2 note naming F02.C4: its condition is not part of those codes, and both may be reported when the patient has both.

  • F06 Other mental disorders due to known physiological condition
    dementia as classified in F01-F02 names F01-F02, which includes this code
  • F63.1 Pyromania
    mental disorders due to known physiological condition (F01-F09) names F01-F09, which includes this code
  • F63.2 Kleptomania
    stealing in mental disorders due to known physiological condition (F01-F09) names F01-F09, which includes this code

Use Additional Code 5

These codes say to use an additional code from the note, and F02.C4 is one of the codes named.

  • A81 Atypical virus infections of central nervous system
    dementia with anxiety (F02.84, F02.A4, F02.B4, F02.C4)
  • G10 Huntington's disease
    dementia with anxiety (F02.84, F02.A4, F02.B4, F02.C4)
  • G20 Parkinson's disease
    dementia with anxiety (F02.84, F02.A4, F02.B4, F02.C4)
  • G30 Alzheimer's disease
    dementia with anxiety (F02.84, F02.A4, F02.B4, F02.C4)
  • G31 Other degenerative diseases of nervous system, not elsewhere classified
    dementia with anxiety (F02.84, F02.A4, F02.B4, F02.C4)

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.

CCSR NVS011
Neurocognitive disorders
Default principal diagnosis: inpatient No · outpatient No

Code History & ChangesHistory

Replacement F02.C4 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
FY 2023AddedAdded to the ICD-10-CM code setEffective October 1, 2022.
FY 2024–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About F02.C4Overview

What is the ICD-10 code for dementia in other diseases classified elsewhere, severe, with anxiety?

The ICD-10-CM code for dementia in other diseases classified elsewhere, severe, with anxiety is F02.C4 (sometimes written as F02C4). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is F02.C4 (Dementia in other diseases classified elsewhere, severe) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report dementia in other diseases classified elsewhere, severe, with anxiety on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does F02.C4 group to?

On inpatient claims, dementia in other diseases classified elsewhere, severe, with anxiety maps to MS-DRG 884 (organic Disturbances and Intellectual Disability), which carries a relative weight of 1.5998. Higher weights mean higher Medicare reimbursement.

Is F02.C4 a CC or MCC?

CMS lists F02.C4 as a CC (complication or comorbidity) for FY 2027. 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.C4 be a principal diagnosis?

No. This is a manifestation code: dementia in other diseases classified elsewhere, severe, with anxiety describes the manifestation of an underlying disease rather than the disease itself, so the underlying condition is sequenced first.

What HCC is F02.C4?

F02.C4 (dementia in other diseases classified elsewhere, severe, with anxiety) maps to CMS-HCC Category 125 (Dementia, Severe), commonly written as HCC 125, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. 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.C4 risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, F02.C4 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). HCC 125 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 125 category page.