CMS Transmittal R13074CP (CR 13882), § Attachment A. Invalid Hospice Principal Diagnosis Codes

ICD-10-CM Diagnosis Code ICD-10-CM Diagnosis Code Description

F02.80 Dementia in other diseases classified elsewhere, unspecified

severity, without behavioral disturbance, psychotic disturbance,

mood disturbance, and anxiety

F02.811 Dementia in other diseases classified elsewhere, unspecified

severity, with agitation

F02.818 Dementia in other diseases classified elsewhere, unspecified

severity, with other behavioral disturbance

F02.82 Dementia in other diseases classified elsewhere, unspecified

severity, with psychotic disturbance

F02.83 Dementia in other diseases classified elsewhere, unspecified

severity, with mood disturbance

F02.84 Dementia in other diseases classified elsewhere, unspecified

severity, with anxiety

F02.A0 Dementia in other diseases classified elsewhere, mild, without

behavioral disturbance, psychotic disturbance, mood disturbance,

and anxiety

F02.A11 Dementia in other diseases classified elsewhere, mild, with agitation

F02.A18 Dementia in other diseases classified elsewhere, mild, with other

behavioral disturbance

F02.A2 Dementia in other diseases classified elsewhere, mild, with

psychotic disturbance

F02.A3 Dementia in other diseases classified elsewhere, mild, with mood

disturbance

F02.A4 Dementia in other diseases classified elsewhere, mild, with anxiety

F02.B0 Dementia in other diseases classified elsewhere, moderate, without

behavioral disturbance, psychotic disturbance, mood disturbance,

and anxiety

F02.B11 Dementia in other diseases classified elsewhere, moderate, with

agitation

F02.B18 Dementia in other diseases classified elsewhere, moderate, with

other behavioral disturbance

F02.B2 Dementia in other diseases classified elsewhere, moderate, with

psychotic disturbance

F02.B3 Dementia in other diseases classified elsewhere, moderate, with

mood disturbance

F02.B4 Dementia in other diseases classified elsewhere, moderate with

anxiety

F02.C0 Dementia in other diseases classified elsewhere, severe, without

behavioral disturbance, psychotic disturbance, mood disturbance,

and anxiety

F02.C11 Dementia in other diseases classified elsewhere, severe, with

agitation

F02.C18 Dementia in other diseases classified elsewhere, severe, with other

behavioral disturbance

F02.C2 Dementia in other diseases classified elsewhere, severe, with

psychotic disturbance

F02.C3 Dementia in other diseases classified elsewhere, severe, with mood

disturbance

F02.C4 Dementia in other diseases classified elsewhere, severe with anxiety

F03.90 Unspecified dementia, unspecified severity, without behavioral

disturbance, psychotic disturbance, mood disturbance, and anxiety

F03.91 Unspecified dementia, unspecified severity, with behavioral

disturbance

F03.911 Unspecified dementia, unspecified severity, with agitation

F03.918 Unspecified dementia, unspecified severity, with other behavioral

disturbance

F03.92 Unspecified dementia, unspecified severity, with psychotic

disturbance

F03.93 Unspecified dementia, unspecified severity, with mood disturbance

F03.94 Unspecified dementia, unspecified severity, with anxiety

F03.A0 Unspecified dementia, mild, without behavioral disturbance,

psychotic disturbance, mood disturbance, and anxiety

F03.A11 Unspecified dementia, mild, with agitation

F03.A18 Unspecified dementia, mild, with other behavioral disturbance

F03.A2 Unspecified dementia, mild, with psychotic disturbance

F03.A3 Unspecified dementia, mild, with mood disturbance

F03.A4 Unspecified dementia, mild, with anxiety

F03.B0 Unspecified dementia, moderate, without behavioral disturbance,

psychotic disturbance, mood disturbance, and anxiety

F03.B11 Unspecified dementia, moderate, with agitation

F03.B18 Unspecified dementia, moderate, with other behavioral disturbance

F03.B2 Unspecified dementia, moderate, with psychotic disturbance

F03.B3 Unspecified dementia, moderate, with mood disturbance

F03.B4 Unspecified dementia, moderate, with anxiety

F03.C0 Unspecified dementia, severe, without behavioral disturbance,

psychotic disturbance, mood disturbance, and anxiety

F03.C11 Unspecified dementia, severe, with agitation

F03.C18 Unspecified dementia, severe, with other behavioral disturbance

F03.C2 Unspecified dementia, severe, with psychotic disturbance

F03.C3 Unspecified dementia, severe, with mood disturbance

F03.C4 Unspecified dementia, severe, with anxiety

F05. Delirium due to known physiological condition

(note currently on the FY 2025

MCE unacceptable pdx list)

F06.0 Psychotic disorder with hallucinations due to known physiological

condition

F06.1 Catatonic disorder due to known physiological condition

F06.2 Psychotic disorder with delusions due to known physiological

condition

F06.3 Mood disorder due to known physiological condition

F06.30 Mood disorder due to known physiological condition, unspecified

F06.31 Mood disorder due to known physiological condition with

depressive features

F06.32 Mood disorder due to known physiological condition with major

depressive-like episode

F06.33 Mood disorder due to known physiological condition with manic

features

F06.34 Mood disorder due to known physiological condition with mixed

features

F06.8 Other specified mental disorders due to known physiological

condition

F07.0 Personality change due to known physiological condition

F07.81 Postconcussional syndrome

F07.89 Other personality and behavioral disorders due to known

(note currently on the FY 2025 physiological condition

MCE unacceptable pdx list)

F07.9 Unspecified personality and behavioral disorder due to known

physiological condition

F09. Unspecified mental disorder due to known physiological condition

R53.81 Other malaise

R53.82 Chronic fatigue, unspecified

R53.83 Other fatigue

R54. Age-related physical debility

R62.7 Adult failure to thrive