ICD 10 for intellectual disability

ICD 10 code for intellectual disability, intellectual disability ICD 10 code

Intellectual Disability ICD 10 code is a code that many speech-language pathologists need to use in their daily documentation. That includes referrals, therapy notes, and evaluation reports. 

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Approximately 1 to 3% of the population has an Intellectual Disability. Intellectual Disability is a term used to describe “when there are limits to a person’s ability to learn at an expected level and function in daily life,” according to the Centers for Disease Control (CDC),  

The Intellectual Disability ICD 10 code range is F70-F79. The individual code used within this range depends on the severity level of the intellectual disability (i.e., F70 is used for Mild Intellectual Disabilities and F72 is used for Profound Intellectual Disabilities). 

Here we’ll guide you through the Intellectual Disability ICD 10 codes, including how to code specific severity levels of the disability, requirements to follow, and mistakes to avoid.   

What is the Intellectual Disability ICD 10 Code?
An Intellectual Disability is characterized by 3 features: 
  • Cognitive deficits

  • Delays in adaptive function 

  • An onset of anytime before a child turns 18 (even prior to birth) 

Prenatal factors (genetic syndromes such as Fragile X Syndrome and Down Syndrome) can cause Intellectual Disability. Another possible cause is environmental factors, with the largest one being Fetal alcohol syndrome. 

If a client has an intellectual disability, the therapist must use the appropriate ICD 10 code to document this. ICD 10 is the official system used in the United States (owned by the World Health Organization (WHO)) to assign health care codes that correspond to various diagnoses and procedures.

The applicable Intellectual Disability ICD 10 code within the range of F70-F70 should be included in documentation and charges for procedures for a client with Intellectual Disability. This can help ensure compliance with HIPAA regulations and payment by Medicare, Medicaid, and private insurance companies. 

If the most accurate Intellectual Disability ICD 10 code is not used, insurance claims may be denied or delayed. For these reasons, it’s important to be familiar with Intellectual Disability ICD 10 codes pertinent to your clients, such as the one for Intellectual Disability. 

Intellectual Disability ICD 10 Codes

The Intellectual Disability ICD 10 Code range is F70-F79. In the CDC’s National Classification, this falls under Chapter 5: Mental, Behavioral and Neurodevelopmental Disorders (F01-F79). 

Professionals working with the client should use the specific ICD 10 code that matches the patient’s severity level for the intellectual disability:

Note: Codes under F78 with a higher degree of specificity includes codes that are valid for claim submission, such as: 
  • F78.A1: SYNGAP1-related intellectual disability

  • F78.A9: Other genetic related intellectual disability

Other ICD 10 codes for speech therapy that may be frequently used with an ICD 10 for Intellectual Disability include:

  • R48.8: Other Symbolic Dysfunctions (about 10% of individuals with Intellectual Disability also have a diagnosis of Autism Spectrum Disorder or autistic traits.) 

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How to code for Intellectual Disability

According to the American Speech-Language Hearing Association (ASHA), professionals should first code any associated physical or developmental disorders. 

Therapists next should use the specific code within the range of F70-F79 (see above) that reflects the severity level of the client’s intellectual disability. 

Avoid using some common errors when coding for intellectual disability using ICD 10 codes. 

The codes in this range exclude borderline intellectual functioning. For clients with an IQ above 70 to 84, the Intellectual Disability ICD 10 code R41.83 should be used.  

A requirement for using one of the ICD 10 codes for Intellectual Disability is that there should be documented IQ testing completed, showing the client has an IQ that falls within the range of the code you are using. 

Coding changes

Updates to ICD 10 codes are released each year and go into effect October 1st. SLP’s should stay up to date on changes to the ICD 10 codes for Intellectual Disability in order to comply with HIPAA requirements and payers such as insurance providers. Therapists can find accurate information on the latest speech therapy ICD 10 code updates on the CMS website or by using the CDC’s ICD 10-CM Lookup tool.

Resources through TheraPlatform

Individuals with Intellectual Disability (ID) typically have delayed language and pragmatic skills. SLPs can also stay up to date on coding changes to the Intellectual Disability ICD 10 code and the most common, accurate speech therapy ICD 10 codes through TheraPlatform.

TheraPlatform, an all-in-one, secure EHR, practice management and teletherapy software, makes it easy to use ICD 10 codes accurately with its speech therapy ICD 10 code lookup. They also offer a 30-day, free trial with no credit card required. Cancel anytime.

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