Rhode Island Early Intervention

Rhode Island Early Intervention

ICD-9 and ICD-10 CODES ESTABLISHED CONDITIONS LIST AND SIGNIFICANT DEVELOPMENTAL DELAY

All children diagnosed with established conditions that have a high probability of resulting in developmental delay, are eligible for early intervention services until the child's third birthday, unless a change in the status of a diagnosis or condition resolves with medical/surgical treatment. Diagnosis must be made by a physician or other appropriately licensed professional and documentation of medical diagnosis is required. If a medical diagnosis or condition is not included in the RI Early Intervention Established Conditions List and it is a condition associated with developmental delay, approval for its use as Single Established Condition by the Lead Agency is required. Conditions listed with an asterisk * may be used only in determining initiial eligibility and require eligibilty to be re-determined in 1 year. These children must meet the criteria for Significant Developmental Delay at that time or be diagnosed with another qualifying condition. Conditions include but are not limited to the following listing. ICD-9 codes with an x indicate that the condition has several types. Additional digits for the specific type are required.

SENSORY CONDITIONS

CENTRAL NERVOUS SYSTEM DISORDERS (Continued)

BLINDNESS

742.2 Q04.3 Lissencephaly

369.00 H54.0 Blindness, both eyes

322.9 G03.9 Meningitis with negative long-term effects

369.60 H54.40 Blindness, one eye

742.1 Q02

Microcephaly

377.75 H47.619 Cortical Blindness/Cortical Vision Impairment

292.0 *P96.1 Neonatal Abstinence Syndrome

377.10 H47.20 Optic Nerve Atrophy

742.2 Q04.3 Polymicrogyria

362.21 *H35.109 Retinopathy of Prematurity

780.39 R56.9 Seizure disorder (repetitive, recurrent)

LOW VISION

345.60 G40.xxx Spasms, infantile

369.20 H54.2 Low vision, both eyes

741.00 Q05.4 Spina bifida with hydrocephalus

(20/70 best acuity with correction)

741.90 Q05.8 Spina bifida without mention of hydrocephalus

369.70 *H54.50 Low vision, one eye

767.4 P11.5 Spinal Cord Injury at birth

HEARING LOSS (permanent)

952.9 S14.109A Spinal Cord Injury not at birth

389.9 H91.93 Hearing impairment, bilateral

741.90 Q05.8 Spinal Lipomeningocele

389.9 H91.90 Hearing impairment, unilateral

759.6 Q85.8 Sturge-Weber disease

389.12 H90.5 Neural hearing loss/auditory neuropathy

CHROMOSOMAL DISORDERS

CANCERS

429.3 Q93.4 Cat Cry Syndrome (Cri-du-Chat)

199.1 C80.1 Cancer, Other (not included on this list)

758.x Q90.xx Chromosomal Anomaly (including Trisomies,

208.90 C91-95x Leukemia

Deletions, Duplications, Translocations,

202.80 C83.7x Lymphoma

Inversions, Rings and Isochromosome)

191.9 C71.9 Malignant neoplasm of brain

Exceptions: Klinfelter's Syndrome, Turner Syndrome)

189.0 C64.9 Malignant neoplasm of kidney

759.8 Q87.1 Cornelia De Lange Syndrome

170.9 C41.9 Osteosarcoma

758.0 Q90.9 Down Syndrome

171.4 C49.3 Rhabdomyosarcoma

759.83 Q99.2 Fragile X Syndrome

CARDIAC CONDITIONS

759.81 Q87.1 Prader-Willi Syndrome

745.69 Q21.2 Atrioventricular canal defect

758.33 Q93.88 Smith-Magenis Syndrome

425.x

Cardiomyopathy

METABOLIC DISORDERS

747.1 Q25.1 Coarctation of the aorta

270.6 E72.20 Disorders of urea cycle metabolism

416.0 I27.0 Hypertension, pulmonary

270.9 E72.9 Amino acid metabolism disorder

746.7 Q23.4 Hypoplastic left heart syndrome

272.6 E88.1 Congenital lipodystrophy

746.9 Q24.9 Major cardiac anomaly, other (not included on this list) 271.1 *E74.21 Galactosemia

745.2 Q21.3 Tetralogy of Fallot

330.1 E75.19 Gangliosidosis

745.10 Q20.3 Transposition of great vessels

271.0 E74.00 Glycogen storage disease

CENTRAL NERVOUS SYSTEM DISORDERS

277.5 E76.01 Hurler Syndrome

759.89 Q04.0 Aicardi syndrome

275.3 E83.39 Hypophosphatasia

740.0 Q00.0 Anencephaly

277.85 E71.310 LCHAD (Long Chain Acyl CoA Dehydrogenase Deficiency)

334.8 G11.3 Ataxia-Telangiectasia

270.3 *E71.0 Maple syrup urine disease/Methylmalonic acidemia

742.4 Q04.8 Brain Sclerosis

759.8 E83.09 Menkes Syndrome

335.22 G12.22 Bulbar palsy

277.5 E76.3 Mucopolysaccharidosis

742.4 Q04.8 Cerebral atrophy, congenital

271.8 E74.8 Other specified disorders of carbohydrate transport

343.9 G80.x Cerebral palsy

and metabolism

436.9 I61.9 Cerebrovascular accident (CVA)

270.7 E72.3 Propionic acidemia

742.4 Q04.6 Congenital Schizencephaly

757.1 Q87.1 Sjogren-Larsson Syndrome

742.3 Q03.1 Dandy-Walker malformation

330.1 E75.02 Tay-Sachs disease

343.0 G80.1 Diplegia

SKELETAL DISORDERS

323.9 G04.90 Encephalitis

714.30 M08.00 Arthritis, juvenile rheumatoid

742.0 Q01.9 Encephalocele

754.89 Q74.3 Arthrogryposis

348.30 G93.4 Encephalopathy

757.39 Q82.8 Beals Syndrome

345.90 G40.9xx Epilepsy

755.59 Q74.0 Cleidocranial Dysostosis

342.90 G81.90 Hemiparesis/Hemiplegia

756.0 Q75.0 Craniostenosis

742.2 Q04.02 Holoprosencephaly/Hypoplasia of the brain

756.0 Q75.9 Crouzon's Syndrome

742.3 Q04.3 Hydranencephaly

352.6 Q87.0 Mobius sequence

345.60 G40.8xx Hypsarrhythmia

756.0 Q75.0 Nager-de Reynier Syndrome

772.13 P52.21 Intraventricular hemorrhage (grade 3 )

756.51 Q78.0 Osteogenesis imperfecta

772.14 P52.22 Intraventricular hemorrhage (grade 4)

755.30 Q68.8 Proximal Focal Femoral Deficiency (PFFD w/fibula hemimelia)

330.0 E75.25 Leukodystrophy/Canavan disease

754.89 *Q68.1 Radial Club Hand

October 2015 ICD-9/ICD10 Codes Established Conditions List and Developmental Delay

Rev Feb 2016

ICD-9 and ICD-10 CODES ESTABLISHED CONDITIONS LIST

OTHER DISORDERS

OTHER DISORDERS (Continued)

755.4 Q73.0 Absence of limb

771.0 P35.00 Rubella, congenital

756.4 Q77.4 Achondroplasia

754.2 M41.00 Scoliosis (congenital, severe)

658.8 *P02.8 ADAM Complex

754.1 *Q68.0 Torticollis, congenital

042 B20

AIDS

771.2 P37.1 Toxoplasmosis, congenital

284.9 D61.9 Aplastic anemia

854.00 S09.8XXS Traumatic Head Injury

299.00 F84.0 Autism

759.5 Q85.1 Tuberous Sclerosis

749.20 *Q37.9 Cleft lip and palate

749.00 *Q35.9 Cleft palate

OTHER SYNDROMES

771.1 P35.1 Congenital CMV - Cytomegalovirus

759.89 Q44.7 Alagille Syndrome

759.4 Q89.4 Conjoined twin

759.89 Q93.5 Angelman Syndrome

277.0x E84.x Cystic fibrosis

755.55 Q87.0 Apert Syndrome

259.4 E34.3 Dwarfism

299.80 F84.5 Asperger Syndrome

757.39 Q81.9 Epidermolysis Bullosa

759.89 Q87.3 Beckwith-Wiedemann Syndrome

767.6 P14.0 Erb's palsy (Brachial Plexis injury)

284.01 D61.0 Blackfan-Diamond Syndrome

783.41 *R62.51 Failure to Thrive

757.33 Q82.3 Bloch-Sulzberger Syndrome

284.09 D61.09 Fanconi Anemia

758.3 Q92.8 Cat Eye Syndrome

307.59 F98.29 Feeding Disorder

759.89 Q89.8 CHARGE Syndrome

756.79 Q79.3 Gastroschisis

759.89 Q87.1 Cockayne Syndrome

754.0 Q67.4 Hemifacial Microsomia

279.11 D82.1 DiGeorge Syndrome

771.2 *P35.2 Herpes, congenital

756.83 Q79.6 Ehlers-Danlos Syndrome

G91.xx Hydrocephalus

448.1 I78.1 Epidermal Nevus Syndrome

778.0 P83.2 Hydrops-Fetalis

581.9 N04.9 Epstein's Syndrome

243 E00.9 Hypothyroidism, congenital

760.71 P04.3 Fetal Alcohol Syndrome

774.7 P57.8 Kernicterus

756.0 Q87.0 Goldenhar Syndrome

984.9 *T56.OX1A Lead Poisoning (15 mg/dl venous lead level or greater) 756.16 Q76.1 Klippel-Feil Syndrome

330.8 G31.82 Leigh's Disease

755.8 Q74.8 Larsen Syndrome

573.9 K76.9 Liver disease and/or dysfunction

759.89 Q87.1 Noonan Syndrome

765.01 *P07.01 Very Low Birth Weight ................
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