International Classification of Disease, 10th Revision (ICD-10 ...

Diagnostic Codes Related to Family Infant Toddler (FIT) Program

International Classification of Disease, 10th Revision (ICD-10) Diagnostic Codes Related to Family Infant Toddler (FIT) Program

Revised October 2015

The following relevant diagnosis codes under the four Family Infant Toddler Program eligibility categories are taken directly from the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM).

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Revised October 2015

Diagnostic Codes Related to Family Infant Toddler (FIT) Program

Introduction:

The following is a guide for Family Infant Toddler (FIT) Program providers to determine the whether the child's medical diagnosis meets eligibility under the "Established Condition" or "Medical / Biological Risk", in accordance with the Requirements for Family Infant Toddler Early Intervention Services (NMAC 7.30.8). This guide is also to be used to determine the diagnostic billing codes (ICD-10 International Classification of Diseases) to be entered into FIT-KIDS (Key Information Data System) for any the FIT eligibility criteria.

This guide is categorized by four main categories of Developmental Delay, Established Condition, Medical/Biological Risk Condition, and Environmental Risk Factors. All codes have been converted from the ICD-9 to ICD-10 mapping.

The categories of Established Condition, and Medical/Biological Risk Condition have their own subcategories of the following: Genetic Disorders; Mental/Psychosocial Disorders (DC: 0-3 diagnosis are indicated in bold); Neurologic/Musculoskeletal; Perinatal Factors; Physical Impairments; and Sensory Abnormalities.

Reminder: Eligibility determination in the categories of Medical/Biological Risk Condition and Established Condition shall be made by a license Medical Practitioner.

The category of Environmental Risk Factors have subcategories of the following: Other personal history presenting hazards to health; Family history of certain chronic disabling diseases; family history of certain other specific conditions; family history of other conditions; health supervision of a child; housing, household, and economic circumstances; other family circumstances; and other psychosocial circumstances.

Reminder: Eligibility determination in the category of Environmental Risk Factors shall be made using the Environmental Risk Assessment (ERA) tool approved by the FIT program.

Any questions regarding conditions not on this guide must be directed to your FIT Manager who will work with a New Mexico Department of Health Medical Director/Physician to determine whether a proposed condition will be recognized. Reminder that there are 100,000 more codes in the ICD-10 conversion which makes the mapping process take longer.

Family Infant Toddler (FIT) Providers may keep this document electronically and in print. Note, that the electronic version has the option to find sections by clicking the table of contents (hyperlinks), diagnosis and ICD-10 Codes can also be found by clicking CTRL+F.

Note: for billing purposes through FIT-KIDS all codes that are not listed on the drop-down list may be entered in the Field/Box of "Other ICD-10 Code".

Please contact your FIT Program Manager if you have any questions.

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Revised October 2015

Diagnostic Codes Related to Family Infant Toddler (FIT) Program Table of Contents

DEVELOPMENTAL DELAY....................................................................................................................................................................................................................................................................... 5

ESTABLISHED CONDITION: GENETIC DISORDERS....................................................................................................................................................................................................................... 6

ESTABLISHED CONDITION: NEUROLOGIC/MUSCULOSKELETAL ......................................................................................................................................................................................... 10

ESTABLISHED CONDITION: PERINATAL FACTORS .................................................................................................................................................................................................................... 12

ESTABLISHED CONDITION: PHYSICAL IMPAIRMENTS............................................................................................................................................................................................................. 13

ESTABLISHED CONDITION: SENSORY ABNORMALITIES ......................................................................................................................................................................................................... 14

MEDICAL/BIOLOGICAL RISK CONDITION: GENETIC DISORDERS........................................................................................................................................................................................ 17

MEDICAL/BIOLOGICAL RISK CONDITION: MENTAL/PSYCHOSOCIAL DISORDERS....................................................................................................................................................... 22

MEDICAL/BIOLOGICAL RISK CONDITION: PERINATAL FACTORS ....................................................................................................................................................................................... 29

MEDICAL/BIOLOGICAL RISK CONDITION: PERINATAL FACTORS (CONTINUED) .......................................................................................................................................................... 30

MEDICAL/BIOLOGICAL RISK CONDITION: PHYSICAL IMPAIRMENTS................................................................................................................................................................................ 31

MEDICAL/BIOLOGICAL RISK CONDITION: SENSORY ABNORMALITIES ............................................................................................................................................................................ 32

MEDICAL/BIOLOGICAL RISK CONDITION: SENSORY ABNORMALITIES (CONTINUED) ............................................................................................................................................... 33

ENVIRONMENTAL RISK FACTORS: PERSONAL HISTORY PRESENTING HAZARD TO HEALTH ................................................................................................................................. 34

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Diagnostic Codes Related to Family Infant Toddler (FIT) Program

ENVIRONMENTAL RISK FACTORS: FAMILY HISTORY OF CERTAIN CHRONIC DISABLING DISEASES ................................................................................................................... 34 ENVIRONMENTAL RISK FACTORS: FAMILY HISTORY OF OTHER CONDITIONS ............................................................................................................................................................. 35 ENVIRONMENTAL RISK FACTORS: HEALTH SUPERVISION OF INFANT OR CHILD ....................................................................................................................................................... 35 ENVIRONMENTAL RISK FACTORS: HOUSING, HOUSEHOLD, AND ECONOMIC CIRCUMSTANCES......................................................................................................................... 36 ENVIRONMENTAL RISK FACTORS: OTHER FAMILY CIRCUMSTANCES .............................................................................................................................................................................. 36 ENVIRONMENTAL RISK FACTORS: OTHER FAMILY CIRCUMSTANCES (CONTINUED) ................................................................................................................................................. 37 ENVIRONMENTAL RISK FACTORS: OTHER PSYCHOSOCIAL CIRCUMSTANCES.............................................................................................................................................................. 37

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Revised October 2015

Diagnostic Codes Related to Family Infant Toddler (FIT) Program

Developmental Delay A delay of 25% or more, after correction for prematurity, in one or more of the following areas of development: cognitive; communication; physical/motor; social or emotional; or adaptive of the following: (NMAC 7.30.8.10.9 Requirements for Family Infant Toddler Early Intervention Services.)

Condition Type Development Development Development Development Development

ICD-10 Code F70 F71 F72 F73 F79

Mild Intellectual Disabilities

Condition/Diagnosis

Moderate Intellectual Disabilities

Severe Intellectual Disabilities

Profound Intellectual Disabilities

Unspecified Intellectual Disabilities

Development Development Development Development Development

F80.1 F80.2 F80.81 F80.89 F82

Expressive Language Disorder Mixed Receptive-Expressive Language Disorder Childhood Onset Fluency Disorder Other developmental disorders of speech and language Specific Developmental Disorder of Motor Functions (Mixed Development Disorder)

Development F84.0

Autistic Disorder (DC 0-3 R: 710 Multisystem Development Disorder)

Development Development Development

F84.9 F88 F89

Pervasive Development Disorder (PDD), Unspecified Other disorders of psychological development Mixed Development Disorder Other disorders of psychological development Other Specified Delays in Development

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Revised October 2015

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