Vascular dementia, severe, with psychotic disturbance

This code describes a severe form of vascular dementia characterized by significant cognitive decline due to cerebrovascular disease, accompanied by psychotic symptoms such as hallucinations or delusions. The cognitive impairment is severe enough to significantly interfere with independence in activities of daily living.

Apply this code when documentation explicitly states a diagnosis of severe vascular dementia with co-occurring psychotic features. This typically involves a patient exhibiting severe memory loss, executive dysfunction, and behavioral disturbances like paranoia or disorganized thought processes directly attributable to vascular brain injury.

• Ensure documentation specifies "severe" vascular dementia and explicitly mentions "psychotic disturbance."
• Do not use this code if the psychotic features are due to another primary mental health disorder or substance use.
• Consider sequencing this code after any underlying cerebrovascular conditions if they are still active and being treated.