Experience. Integrity. Advocacy.
Experience. Integrity. Advocacy.

Examining ICD-10-CM Codes for Mental, Behavioral and Neurodevelopmental Disorders – Part 5

ICD-10-CM codes F70-F79 have a new note at the category level pertaining to the sequencing of associated physical or developmental disorders that directs the coder to code first the associated condition. In ICD-9-CM, the opposite is true; the code for the associated condition was an additional code or secondary code.

The terminology used to describe the severity level of intellectual disabilities is the same with mild, moderate, severe, and profound. Additionally, in ICD-10-CM there are separate codes at the category level for other and unspecified. Remember, the recommendation for best practices in ICD-10-CM is to always code to the greatest level of specificity available.

In category F70-F79, there is an Excludes 1 note stating that the diagnosis for borderline intellectual functioning, IQ from 70 to 84, is coded with R41.83 which is in the Symptoms, Signs and Abnormal Clinical Findings Chapter. Compared to ICD-9-CM where V62.89 was used to describe borderline intellectual disabilities, the supplementary classifications (V and E codes) will no longer be used in ICD-10-CM.

INTELLECTUAL DISABILITIES F70-F79 CODE DESCRIPTION
F70 Mild intellectual disabilities IQ level 50-55 to approximately 70; Mild Mental Subnormality
F71 Moderate intellectual disabilities IQ level 35-40 to 50-55; Moderate Mental Subnormality
F72 Severe intellectual disabilities IQ level 20-25 to 35-40; Severe Mental Subnormality
F73 Pofound intellectual disabilities IQ level below 20-25; Profound Mental Subnormality
F78 Other intellectual disabilities
F79 Unspecified intellectual disabilities

 

Let’s look at one last category of codes that will be coded differently in ICD-10-CM: tension headaches. In ICD-9-CM, tension headache is classified as a pain disorder related to psychological factors in Chapter 5. However, that changes in ICD-10-CM where tension headache has been reclassified to Chapter 6 Diseases of the Nervous System (G00-G99).

All types of tension headaches are classified in Chapter 6 under the same subclassification, tension headache, tension-type, episodic tension-type headache, and chronic tension-type headache. Physician documentation will need to include the frequency and type and severity of some symptoms. There will also need to be clear documentation of the etiology and any associated mental or organic illness.

Psychological factors affecting physical conditions (F54) has an Excludes 2 note listing tension type headache (G44.4). These means that the two conditions can be coded together if both are documented as being present by the physician. Finally, the coder will need to look in the documentation for the physician to describe intractability. Here is an example:

ICD-9-CM ICD-10-CM
339.19 Chronic tension-type headache G44.221 Chronic tension-type headache,Intractable

G44.229 Chronic tension-type headache,Non-intractable (Chronic tension-type headache NOS)

Thank you for following this series as we dug deep into the ICD-10-CM, Chapter 5 – Mental, Behavioral, and Neurodevelopmental Disorders. Visit our ICD-10 Updates page for future series on coding for specific specialties.

For more ICD-10 articles, please visit our ICD-10 Updates page.

— Compiled by former CIPROMS ICD-10 Coordinator, Angela Hickman, CPC, CEDC, AHIMA-Approved ICD-10 CM/PCS Trainer, AHIMA Ambassador. All rights reserved. For use or reprint in your blog, website, or publication, please contact us at cipromsmarketing@ciproms.com.

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