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ICD-10-CM F02.B4: Dementia in other diseases classified elsewhere, moderate, with anxiety

F02.B4 is the billable ICD-10-CM code for dementia in other diseases classified elsewhere, moderate, with anxiety, in category F02 (Dementia in other diseases classified elsewhere) of the Mental disorders due to known physiological conditions section. As a principal diagnosis it groups to MS-DRG 884 Organic Disturbances and Intellectual Disability (MDC 19 MDC 19: Mental Diseases and Disorders). It maps to HCC 126 (Dementia, Moderate) in CMS-HCC V28. As a secondary diagnosis it is a CC, excluded with 20 principal diagnoses. 11 LCD billing and coding articles list it as covered.

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: ICD-10-CM code descriptions: FY2027 (effective October 1, 2026); IPPS Table 5 (MS-DRG weights): v44 FY2027 (final rule + CN3) (effective October 1, 2026); ICD-10-CM to HCC mapping: PY2027 initial ICD-10-CM mappings (dates of service 2026) (payment year 2027); Medicare Coverage Database billing and coding articles: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: FY2028 code files, effective October 1, 2027 for the ICD-10-CM code descriptions; FY2028 final rule (August 2027), effective October 1, 2027; an April 1 interim grouper update when CMS issues one for the IPPS Table 5 (MS-DRG weights); PY2028 advance notice (February 2027) and the PY2027 midyear final mapping (spring 2027) for the ICD-10-CM to HCC mapping; weekly, every Thursday for the Medicare Coverage Database billing and coding articles.

Code
F02.B4
billable FY2027 ICD-10-CM code
Category
F02 Dementia in other diseases classified elsewhere
Chapter
5: Mental, Behavioral and Neurodevelopmental disorders (F01-F99)
CC/MCC (MS-DRG v44)
CC
CMS-HCC V28
HCC 126
POA reporting
Required

Tabular list notes for F02.B4

The tabular list has no notes on F02.B4 itself; the notes below apply from its parent headings.

Inherited from F02 (Dementia in other diseases classified elsewhere)

Includes
  • Major neurocognitive disorder in other diseases classified elsewhere
Excludes1 (never coded together)
  • mild neurocognitive disorder due to known physiological condition with or without behavioral disturbance (F06.7-)
Excludes2 (not part of this condition, may be coded together)
  • dementia in alcohol and psychoactive substance disorders (F10-F19, with .17, .27, .97)
  • vascular dementia (F01.5-, F01.A-, F01.B-, F01.C-)
Code first
  • 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)

MS-DRG grouping when F02.B4 is the principal diagnosis

MS-DRG v44 groups for F02.B4 as principal diagnosis
MDCMS-DRGs
19 MDC 19: Mental Diseases and Disorders884

The final group also depends on procedures, secondary diagnoses and discharge status; the MS-DRG lookup for F02.B4 shows the full grouping logic.

CC/MCC status and inpatient edits

As a secondary diagnosis, F02.B4 is a CC under MS-DRG v44, unless the principal diagnosis is one of the 20 codes in its exclusion list. Check F02.B4 against a principal diagnosis.

  • Present on admission: a POA indicator is required on inpatient claims.
  • Medicare Code Editor: manifestation code, not allowed as principal diagnosis.

CMS-HCC V28 risk adjustment

In the PY2027 mapping, F02.B4 maps to HCC 126 (Dementia, Moderate). The HCC lookup shows the RAF weight and the hierarchy.

LCD billing and coding articles that list F02.B4

11 current Medicare billing and coding articles list F02.B4 among the diagnoses that support medical necessity for the services they cover.

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Frequently asked questions

What does ICD-10-CM F02.B4 mean?

F02.B4 means dementia in other diseases classified elsewhere, moderate, with anxiety. It is one of 24 billable codes under F02, dementia in other diseases classified elsewhere.

Which MS-DRG does F02.B4 group to?

As the principal diagnosis, F02.B4 groups to MS-DRG 884 Organic Disturbances and Intellectual Disability (MDC 19 MDC 19: Mental Diseases and Disorders) under MS-DRG v44, before procedures and secondary diagnoses are applied.

Does F02.B4 map to an HCC?

Yes: HCC 126, Dementia, Moderate, in the PY2027 CMS-HCC V28 mapping.

Is F02.B4 a CC or MCC?

F02.B4 is a CC under MS-DRG v44; 20 principal diagnoses exclude it.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

The descriptor and notes are reproduced from the FY2027 ICD-10-CM files; MS-DRG, CC/MCC and HCC facts come from the CMS FY2027 and PY2027 tables. Code from the medical record and the ICD-10-CM Official Guidelines. Not legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.