What's the ICD-10 Code for Intellectual Disability?
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Looking for the ICD-10 code for intellectual disability? This guide provides an overview of the ICD-10 code for intellectual disability, diagnostic criteria, differential diagnoses, and other important codes, including the ICD-10 code for intellectual disability unspecified, as well as moderate and severe presentations.
Determining the right ICD-10 code for intellectual disability is essential for clinicians seeking insurance reimbursement.
Bookmark this article as a reference to use next time you need to access the ICD-10 code for intellectual disability.
What is the ICD-10?
The International Classification of Diseases, Tenth Edition (ICD-10) is a clinical guide published by the World Health Organization (WHO), which contains standard diagnostic language for both medical and mental health conditions. The ICD-10-CM is a clinical modification of the ICD-10 used specifically for diagnosis codes.
The use of this standard language helps statisticians identify health and disease trends. Clinicians in the United States also use the American Psychiatric Association (APA) Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), which contains relevant ICD-10 codes as well.
Using the appropriate ICD-10 code for intellectual disability and ensuring the correct insurance billing information is essential to avoid insurance reimbursement delays.
What is the ICD-10 code for intellectual disability?
In the ICD-10, intellectual disabilities are classified under the section “Mental, behavioral, and neurodevelopmental disorders” (F01 to F99), and the sub-section “Intellectual disabilities” (F70-F79). This section also contains the ICD-10 code for intellectual disability moderate and the ICD-10 code intellectual disability severe.
There are a total of six ICD-10 codes for intellectual disability:
- Mild intellectual disabilities (F70)
- Moderate intellectual disabilities (F71)
- Severe intellectual disabilities (F72)
- Profound intellectual disabilities (F73)
- Other intellectual disabilities (F78)
- Other genetic related intellectual disabilities (F78.A)
- SYNGAP1-related intellectual disability (F78.A1)
- Other genetic related intellectual disability (F78.A9)
- ICD-10 code for intellectual disability unspecified (or unspecified intellectual disabilities) (F79)
Please note these diagnoses exclude borderline intellectual functioning. The ICD-10 code borderline intellectual disability (for IQ above 70 to 84) is R41.83.
Diagnosis criteria for intellectual disability
Within the ICD-10, the diagnostic criteria for intellectual disability is limited to IQ test results and varies depending on the severity of the disability.
| Severity of intellectual disability | IQ | ICD-10 code |
| Mild intellectual disabilities | 50 to 70 | F70 |
| Moderate intellectual disabilities | 35 to 49 | F71 |
| Severe intellectual disabilities | 20 to 34 | F72 |
| Profound intellectual disabilities | Below 20 | F73 |
However, IQ score alone is no longer the standard criteria to classify intellectual disabilities. There are more specific diagnostic criteria within the DSM-5.
Intellectual disability appears in the DSM-5 as “intellectual developmental disorders.” The ICD-11 (the latest version of the ICD guide) renamed the disorder to “disorders of intellectual development” from “mental retardation,” which carried negative connotations.
The main diagnostic criteria are:
- Deficits in intellectual functions involved in reasoning, planning, problem solving, abstract thinking, learning (experiential and academic), and judgment, as confirmed by a clinical assessment and intelligence testing.
- Deficits in adaptive functioning which fail to meet sociocultural and developmental standards relating to independence and social responsibilities. The client requires additional support, otherwise their day-to-day functioning is impaired.
- Onset of intellectual and adaptive deficits during the developmental period.
Clinicians should specify severity as:
- Mild
- Moderate
- Severe
- Profound
Note: The DSM-5 requires the specificity to be on the basis of adaptive functioning and not IQ results, as functioning determines the level of support required. There is more detail regarding practical, social, and conceptual deficits for each level of severity within the DSM-5.
Differential diagnoses
While some patients may meet some of the criteria for intellectual developmental disorders, there may be a more appropriate diagnosis to consider, such as:
- Major and mild neurocognitive disorders: Intellectual developmental disorder is distinct from neurocognitive disorders which are more specific to a loss of cognitive function. However, both may co-occur, such as a person with down syndrome also having dementia.
- Communication disorders and specific learning disorders: These disorders are specific to communication and learning domains rather than deficits in intellectual and adaptive functioning.
- Autism spectrum disorder (F84.0): Intellectual developmental disorder is common in people with autism spectrum disorder (ASD).
- Global developmental delay (F88): This diagnosis is reserved for children under 5 when clinical severity cannot be assessed during childhood, and they fail to meet developmental milestones.
- Unspecified intellectual developmental disorder: This diagnosis (the ICD-10 code for intellectual disability unspecified is F79) is typically for individuals over 5 years old when assessment is too difficult due to sensory or physical impairments.
Neurodevelopmental disorders commonly co-occur with other mental and medical conditions, such as cerebral palsy and epilepsy, which are said to be four times higher than the general population, according to the DSM-5.
How to find the right ICD-10 code for intellectual disability
The full list of ICD-10 codes are available in both digital and book formats:
- The WHO official ICD-10 under the section of Mental and behavioral disorders and sub-section, Mental retardation (F70 to F79)
- ICD-10-CM Data, a searchable ICD-10 database under the section Intellectual disabilities (F70 to F79)
- DSM-5 in the textbook and digital version
Note: While the DSM does contain accurate ICD-10 codes, they may not align with the most recent ICD version and diagnostic criteria and other indicators may differ.
Sources
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
- Girimaji, Satish Chandra; Pradeep V, Arul Jayendra. Intellectual Disability in International Classification of Diseases-11: A Developmental Perspective. Indian Journal of Social Psychiatry.
- Lee K, Cascella M, Marwaha R. Intellectual Disability. (2023). StatPearls Publishing.
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