F03.C2 Unspecified dementia, severe, with psychotic disturbance

Billable ICD-10-CM code, FY2026. Acts as a Complication or Comorbidity (CC) as a secondary diagnosis.

Applicable to

• Unspecified dementia, severe, with psychotic disturbance such as hallucinations, paranoia, suspiciousness, or delusional state

Applies from F03 Unspecified dementia

Applicable to

• Major neurocognitive disorder NOS
• Presenile dementia NOS
• Presenile psychosis NOS
• Primary degenerative dementia NOS
• Senile dementia NOS
• Senile dementia depressed or paranoid type
• Senile psychosis NOS

Excludes2 (not included here)

• dementia with delirium or acute confusional state (F05)
• mild memory disturbance due to known physiological condition (F06.8)

Risk adjustment (HCC)

• CMS-HCC V28: HCC 125 — Dementia, Severe
• RxHCC V08: HCC 112 — Dementia, Except Alzheimer's Disease
• ESRD V24: HCC 51

MS-DRG index

Defines the logic of DRG(s) 884 in MDC 19.

Medicare Code Edits (MCE v43.1 (April 2026))

• Adult diagnoses (age 15 through 124): Age conflict edit. These diagnoses are clinically expected only in patients age 15 through 124.

Code annotations containing back-references to F03.C2

Back-references to F03.C

• Code First: Z91.83 Wandering in diseases classified elsewhere ("unspecified dementia with behavioral disturbance (F03.9-, F03.A-, F03.B-, F03.C-)")

Back-references to F03

• Type 1 Excludes: F06 Other mental disorders due to known physiological condition ("unspecified dementia (F03.-)")
• Type 1 Excludes: F06.7 Mild neurocognitive disorder due to known physiological condition ("dementia (F01.-, F02.-, F03.-)")
• Type 2 Excludes: F63.1 Pyromania ("mental disorders due to known physiological condition (F01-F09)")
• Type 2 Excludes: F63.2 Kleptomania ("stealing in mental disorders due to known physiological condition (F01-F09)")
• Type 1 Excludes: G30 Alzheimer's disease ("senile dementia NOS (F03.-)")
• Type 1 Excludes: G31.84 Mild cognitive impairment of uncertain or unknown etiology ("dementia (F01.-, F02.-, F03.-)")
• Type 1 Excludes: R54 Age-related physical debility ("senile psychosis (F03.-)")

Diagnosis Index entries for F03.C2

• Dementia (degenerative (primary)) (persisting) (unspecified severity) (without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety) › severe › with › psychotic disturbance (delusional state) (hallucinations) (paranoia) (suspiciousness)

Nearby codes

• F03.C Unspecified dementia, severe
• F03.C0 Unspecified dementia, severe, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
• F03.C1 Unspecified dementia, severe, with behavioral disturbance
• F03.C11 Unspecified dementia, severe, with agitation
• F03.C18 Unspecified dementia, severe, with other behavioral disturbance
• F03.C2 Unspecified dementia, severe, with psychotic disturbance (this code)
• F03.C3 Unspecified dementia, severe, with mood disturbance
• F03.C4 Unspecified dementia, severe, with anxiety