International Classification of Disease, 10th Revision (ICD ...
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).
1 | Page ICD-10 Codes
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.
2 | Page ICD-10 Codes
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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Revised October 2015
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
4 | Page ICD-10 Codes
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 ICD-10 Code
Condition/Diagnosis
Development
F70
Mild Intellectual Disabilities
Development
F71
Moderate Intellectual Disabilities
Development
F72
Severe Intellectual Disabilities
Development
F73
Profound Intellectual Disabilities
Development
F79
Unspecified Intellectual Disabilities
F80.1
Expressive Language Disorder
Development
F80.2
Mixed Receptive-Expressive Language Disorder
Development
F80.81
Childhood Onset Fluency Disorder
Development
F80.89
Other developmental disorders of speech and language
Development
F82
Specific Developmental Disorder of Motor Functions (Mixed Development Disorder)
F84.0
Autistic Disorder (DC 0-3 R: 710 Multisystem Development Disorder)
F84.9
Pervasive Development Disorder (PDD), Unspecified
Development
F88
Other disorders of psychological development Mixed Development Disorder
Development
F89
Other disorders of psychological development Other Specified Delays in Development
Development
Development
Development
5 | Page ICD-10 Codes
Revised October 2015
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