ICD 10 Code for Dementia with Behavioral Disturbance: Coding & Billing Guidelines

Dementia coding can become complicated when a patient experiences behavioral symptoms such as agitation, aggression, wandering, sleep disturbance, or social disinhibition. Selecting the appropriate ICD 10 code for dementia with behavioral disturbance requires more than identifying dementia in the medical record. The coder must review the documented dementia type, severity, underlying condition, and specific behavioral manifestation.

Proper reimbursement and clean claims are another aspect of accurate dementia ICD 10 coding for medical procedures. In the U.S., the reporting system for medical conditions is the ICD-10-CM, which provides detailed standards to follow for making dementia diagnosis.

This article will cover the most common dementia diagnosis codes, what differentiates agitation from other behavioral problems, documentation required, and payment issues for health care providers.

What Is the ICD 10 Code for Dementia with Behavioral Disturbance?

There is no single code for all patients with dementia and behavioral signs. The correct ICD 10 classification for dementia is determined by the underlying disease and the behavioral state noted by the physician.

Several dementia categories employ more specific codes to distinguish between agitation and other behavioral abnormalities for FY2026. For example:

F02.81 is non-billable and should not be submitted when a more specific billable code is available. F02.811 and F02.818 are billable codes in the F02.81 category.

The important aspect is that the coder should not label a “other behavioral disturbance” automatically when behavioral symptoms are present in the chart. The provider’s documentation should support the specific manifestation being reported.

Understanding F02.811 and F02.818

The F02 category applies to dementia in other diseases classified elsewhere. These codes are generally used when the underlying physiological condition is known and the dementia is associated with that condition.

F02.811: Dementia With Agitation

F02.811 describes dementia in other diseases classified elsewhere, unspecified severity, with agitation. This code is appropriate when the provider documents agitation as the behavioral manifestation.

Documentation may describe behaviors such as:

• Restlessness
• Verbal agitation
• Physical agitation
• Repeated disruptive behavior
• Increased irritability associated with dementia

The medical record should establish that the agitation is associated with the documented dementia rather than simply listing agitation as an isolated symptom.

F02.818: Dementia With Other Behavioral Disturbance

F02.818 describes dementia in other diseases classified elsewhere, unspecified severity, with other behavioral disturbance. The code is billable and is used when the documented behavioral manifestation does not fall under the more specifically defined agitation option.

Examples of behavioral manifestations can include documented sleep disturbance, social disinhibition, or sexual disinhibition when supported by the applicable coding instructions.

Because F02 codes are manifestation codes, the underlying physiological condition should also be considered according to the Tabular List instructions. For example, the underlying condition may be Alzheimer’s disease, Huntington’s disease, Parkinson’s disease, or another physiological condition specified.

Unspecified Dementia With Behavioral Disturbance

When the provider has documented dementia but has not established a specific underlying dementia type, the F03 category may apply.

Two important FY2026 codes are:

• F03.911 — Unspecified dementia, unspecified severity, with agitation
• F03.918 — Unspecified dementia, unspecified severity, with other behavioral disturbance

F03.911 is a billable code for unspecified dementia with agitation, while F03.918 is used for unspecified dementia with other behavioral disturbance.

Coders should avoid assuming the dementia type from medications, symptoms, age, or a previous problem list entry. The diagnosis should be supported by the provider’s current documentation.

Dementia With Agitation vs. Other Behavioral Disturbance

One of the most important changes in current dementia coding guidelines is the distinction between agitation and other behavioral manifestations.

For additional clinical context, providers can review the CDC’s information on the signs and symptoms of dementia, including changes affecting memory, communication, reasoning, judgment, and daily functioning.

For example, if the provider specifically documents dementia with agitation, an applicable “with agitation” code should be considered rather than automatically using an unspecified behavioral disturbance code.

On the other hand, documentation describing another qualifying behavioral manifestation may support an “other behavioral disturbance” code.

The difference matters because F02.811 and F02.818 are not the same clinical presentation. F03.911 and F03.918 are similarly described differently.

Coders must always verify the date of service against the current ICD-10-CM Tabular List and any applicable instructional notes. Users can search for specific fiscal year code sets and read the Index, Tabular List, and coding instructions in the CDC ICD-10-CM Browser.

How to Choose the Correct Dementia ICD 10 Code

Accurate dementia diagnosis coding starts with a structured review of the medical record.

Identify the Dementia Type

First identify if the clinician recorded a kind of dementia diagnosis or an unspecified dementia diagnosis.

The record may specify Alzheimer’s disease, vascular dementia, frontotemporal dementia, dementia due to another neurological disorder or dementia that is not mentioned. The underlying diagnosis affects code selection.

Review the Documented Severity

Some dementia code families distinguish severity. Do not infer mild, moderate, or severe dementia based solely on the patient’s symptoms or functional status unless the provider documentation supports the diagnosis required by the code.

Identify the Behavioral Manifestation

Look for specific documentation describing agitation or another behavioral disturbance.

A coder should distinguish between documented agitation and other behavioral symptoms rather than treating every behavioral change as equivalent.

Check Code-First and Additional-Code Instructions

Certain dementia categories require the underlying physiological condition to be coded first. For F02.818, for example, coding references identify an underlying physiological condition such as Alzheimer’s disease or another qualifying condition as subject to the applicable code-first instruction.

The Tabular List should be reviewed before final code assignment.

Verify the Date of Service

ICD-10-CM codes can change from one fiscal year to another. A code that was applicable in an earlier year may have been expanded into more specific codes.

For FY2026, F02.81 is a non-billable category, while F02.811 and F02.818 provide greater specificity.

Documentation Requirements for Dementia Coding

Strong documentation helps coders assign the correct ICD 10 dementia codes and reduces uncertainty during claim review.

A dementia encounter may benefit from documentation that clearly identifies:

• The type or suspected type of dementia
• The underlying neurological or physiological condition
• Dementia severity when clinically established
• Behavioral manifestations
• Agitation or other specific behavioral symptoms
• Relevant assessment findings
• Treatment or management provided
• Changes in symptoms since the previous encounter
• The relationship between dementia and the documented behavioral symptoms

Avoid relying on vague descriptions such as “behavior problems” when the provider can document the actual clinical manifestation.

Complete documentation is also important because official ICD-10-CM guidelines emphasize the relationship between provider documentation and accurate code assignment.

Common Dementia Coding Errors

Several mistakes can create claim problems or inaccurate diagnosis reporting.

Using F02.81 as a Billable Code

F02.81 is not a billable code for FY2026. It is a sub-category of F02. If documentation supports a more specific option select the appropriate billable code e.g., F02.811 or F02.818.

Assuming Every Behavioral Symptom Means Agitation

Behavioral disturbance and agitation are not interchangeable descriptions. The provider’s documentation should determine which code is supported.

Ignoring the Underlying Condition

F02 codes are associated with dementia in other diseases classified elsewhere. Applicable coding instructions may require the underlying physiological condition to be reported.

Coding From Symptoms Alone

Coders should not independently diagnose dementia or determine its type from symptoms. Code assignment should be based on provider documentation and the applicable ICD-10-CM guidelines.

Failing to Check Annual Code Updates

Using an outdated dementia code can create claim and compliance problems. Always verify the code for the applicable date of service.

Dementia Billing Guidelines for Healthcare Providers

Successful dementia billing includes proper diagnosis coding. Claims also must have appropriate procedure coding, documentation, payer information, and medical necessity support.

Providers are responsible to ensure that the diagnosis codes reported on the claim are supported by the services documented at the time of the encounter. The medical record should include billable services such as evaluation and management services, care planning, follow-up visits, etc.

For practices that frequently manage neurological conditions, combining accurate diagnosis coding with specialty-specific billing workflows can help reduce avoidable claim issues.

A practice’s medical coding services can also include reviewing documentation before claims are submitted. This can help identify missing specificity, unsupported diagnoses, or coding inconsistencies before they become payer issues.

How Medical Billing Services Can Support Dementia Claims

Dementia-related claims may involve multiple encounters, chronic disease management, neurological evaluations, and behavioral symptoms. Managing these claims manually can add administrative work for providers.

Professional dementia medical billing services can support practices with:

• ICD-10 diagnosis review
• Claim preparation and submission
• Documentation checks
• Insurance eligibility verification
• Denial management
• Accounts receivable follow-up
• Claim status monitoring
• Payment posting
• Payer communication

For practices that need broader support, medical billing services in Rhode Island can help coordinate billing and revenue cycle processes across different providers and specialties.

Specialty-specific knowledge can be particularly useful for neurological practices. Rhode Island providers can also explore neurology billing services when their practices handle dementia, Alzheimer’s disease, Parkinson’s disease, or other neurological conditions requiring specialized billing workflows.

Practices can also review related guidance on E/M codes in medical billing when evaluating how office and other evaluation and management services are reported alongside appropriate diagnosis coding.

How Coding Accuracy Helps Prevent Dementia Claim Denials

If you make an error on the diagnosis code, your claim may be denied or the payer may ask for documentation or ask questions. Common problems: selecting a non-billable code, using an unspecified code when the record supports more specificity, not following code-first instructions.

Accurate diagnosis selection and supporting documentation are essential parts of the medical coding process, particularly when dementia is documented with specific behavioral symptoms.

A structured dementia medical coding service can review the diagnosis, documentation and applicable coding instructions before submitting the claims.

Denial prevention should not stop at diagnosis coding. Practices should also verify patient eligibility, authorization requirements when applicable, provider enrollment, claim data, and payer-specific requirements.

For practices managing substantial claim volume, integrating coding review with broader revenue cycle management can provide a more consistent billing workflow.

Final Thoughts

Choosing the correct ICD 10 code for dementia with behavioral disturbance requires careful attention to the documented dementia type, underlying condition, severity, and behavioral manifestation. Current ICD-10-CM coding also distinguishes agitation from other behavioral disturbances, making specific documentation increasingly important.

In FY2026, codes such as F02.811, F02.818, F03.911 and F03.918 will be available to provide a more specific option for reporting than the non-billable F02.81 category.

Accurate diagnosis selection as well as complete documentation, claim review, eligibility verification, denial management and accounts receivable follow-up may improve the billing process for healthcare practices. Rhode Island Medical Billing Company offers medical billing services, coding, credentialing, eligibility verification and revenue cycle services to Rhode Island providers for all healthcare specialties.

Frequently Asked Questions About Dementia ICD 10 Codes

What is the ICD 10 code for dementia with behavioral disturbance?

There’s no one code that fits all cases of dementia with behavioral symptoms. FY2026 include F02.811, F02.818, F03.911, and F03.918 codes based on the documented diagnosis and manifestation. Which is right depends on the condition and what the provider documents.

Is F02.81 a billable ICD-10 code?

No. For FY2026, F02.81 is a non-billable category. More specific billable codes include F02.811 and F02.818.

What is the ICD 10 code for dementia with agitation?

The appropriate code depends on the dementia category and underlying condition. Examples include F02.811 for dementia in other diseases classified elsewhere, unspecified severity, with agitation, and F03.911 for unspecified dementia, unspecified severity, with agitation.

Should the underlying disease also be coded?

For applicable F02 categories, yes, the coding instructions require consideration of the underlying physiological condition. Coders should follow the Tabular List instructions for the specific diagnosis.