Alzheimer’s dementia ICD 10

In ICD-10-CM, Alzheimer’s dementia is not captured with a single code. It is recorded as a pair: a code from category G30 for the underlying Alzheimer’s disease, listed first, followed by a code from category F02, dementia in other diseases classified elsewhere, which describes the dementia’s severity and whether it comes with behavioral, psychotic, mood or anxiety symptoms. A common example is G30.1 with F02.80, late-onset Alzheimer’s disease with dementia of unspecified severity and none of those additional disturbances.

This etiology and manifestation structure can feel confusing at first, especially since the F02 category was greatly expanded in the fiscal year 2023 update. The good news is that once you see the logic, the codes become easy to read. This overview is meant for coders, clinicians, students and curious families. It stays high level, and anyone coding professionally should confirm every selection in the current official ICD-10-CM index and tabular list.

Why Two Codes Instead of One

ICD-10-CM uses a convention for conditions that are caused by another disease. The cause, called the etiology, is coded first. The resulting condition, called the manifestation, is coded second. Manifestation codes, including those in F02, are not meant to be listed first or used alone. For Alzheimer’s dementia, the etiology is Alzheimer’s disease in the nervous system chapter, and the manifestation is the dementia in the mental and behavioral chapter. Together they tell the full story: what disease is present and how it is affecting the person’s thinking and behavior.

How the F02 Codes Are Built

Since October 1, 2022, F02 codes describe two things. The first is severity, which can be unspecified, mild, moderate or severe. The second is whether the dementia is accompanied by a behavioral disturbance, a psychotic disturbance, a mood disturbance or anxiety, or none of these.

Within each severity group, the final characters indicate the accompanying symptoms. Broadly, a 1 subgroup covers behavioral disturbance, with separate codes for agitation, such as aggression or combativeness, and for other behavioral disturbances, such as sleep disturbance or disinhibition. A 2 indicates psychotic disturbance, such as hallucinations or delusions, a 3 indicates mood disturbance, such as depression or apathy, and a 4 indicates anxiety. For example, F02.811 describes unspecified severity with agitation. Check the tabular list for the exact wording and any inclusion or exclusion notes.

Worked Examples

1. Late-onset Alzheimer’s with mild dementia, no behavioral or psychiatric symptoms documented: G30.1 followed by F02.A0.
2. Early-onset Alzheimer’s with moderate dementia and documented agitation: G30.0 followed by the moderate-severity agitation code in the F02.B1 subgroup.
3. Alzheimer’s disease, onset not specified, severe dementia with hallucinations: G30.9 followed by F02.C2.
4. Alzheimer’s dementia, severity and symptoms not documented: the appropriate G30 code followed by F02.80.

These illustrations show the logic only. Real records often contain more detail, and each element must be supported by the provider’s notes.

Documentation Clinicians Can Provide

Clinicians can make accurate coding much easier with a few habits. State the diagnosis plainly as Alzheimer’s disease, note whether onset was early or late, describe dementia severity in words such as mild, moderate or severe, and name any accompanying symptoms, for example agitation, hallucinations, depressed mood, anxiety, sleep disturbance or wandering. Updating this summary at each significant visit keeps the record current as the disease changes, so that the codes reflect where the person is now rather than where they were at diagnosis.

Additional Codes That Often Travel With the Pair

• Wandering: ICD-10-CM provides a separate code, Z91.83, for wandering in diseases classified elsewhere, which can be added when documented.
• Delirium: Delirium superimposed on dementia is coded in addition, because it is a distinct, often reversible condition.
• Mixed dementia: When Alzheimer’s coexists with vascular dementia or another cause, each documented condition is coded according to its own instructions.
• Related conditions: Depression, falls and other conditions are coded when documented and relevant to the encounter.

Why Getting It Right Helps Patients

Accurate dementia coding is not just administrative housekeeping. Severity and symptom details help care teams anticipate needs, support eligibility for services, inform hospital and nursing home care planning and make population data more useful for research, including studies that track how dementia care needs change across the country. For a family, it means the record that follows their loved one from clinic to hospital to care community describes them accurately. Most importantly, accurate codes depend on a thorough clinical evaluation, and new memory problems should always be assessed by a doctor before anyone draws conclusions. Sudden confusion or stroke warning signs require emergency care, so call 911.

Frequently Asked Questions

Can F02 be used without a G30 code?

No. F02 codes require the underlying condition to be coded first. With Alzheimer’s dementia, that underlying condition is a G30 code.

What happened to the older F02.80 and F02.81?

F02.80 still exists, now representing unspecified severity without the listed disturbances. The former F02.81 was expanded into more detailed codes, so older references may be out of date.

Is Alzheimer’s dementia coded the same way worldwide?

No. The WHO version of ICD-10 and the newer ICD-11 use different structures, so these rules apply specifically to US ICD-10-CM.

For patient and family information, visit the Alzheimer’s Association at alz.org and the National Institute on Aging at nia.nih.gov. Official code files are published by the CDC at cdc.gov.

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