International Classification of Disease, 10th Revision ...Diagnostic Codes Related to Family Infant...
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Diagnostic Codes Related to Family Infant Toddler (FIT) Program
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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).
Diagnostic Codes Related to Family Infant Toddler (FIT) Program
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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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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
Diagnostic Codes Related to Family Infant Toddler (FIT) Program
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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
Diagnostic Codes Related to Family Infant Toddler (FIT) Program
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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
Development 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)
Development F84.0 Autistic Disorder (DC 0-3 R: 710 Multisystem Development Disorder)
Development 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
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ESTABLISHED CONDITION: Genetic Disorders
A diagnosed physical, mental, or neurobiological condition that has a high probability of resulting in developmental delay. The established condition shall be diagnosed by a health care provider and documentation shall be kept on file. Established conditions include the following: (NMAC 7.30.8.10.9 Requirements for Family Infant Toddler Early Intervention Services.)
Condition Type ICD-10 Code Condition/Diagnosis
Genetic Disorders A81.1 Subacute Sclerosing Panencephalitis
Genetic Disorders D33.2 Benign Neoplasm of Brain, Unspecified
Genetic Disorders E70.20 Disorder of tyrosine metabolism, unspecified
Genetic Disorders E70.21 Tyrosinemia, Type I (Tyrosinosis) and Type II (Richner-Hanhart Syndrome)
Genetic Disorders E70.29 Disorder of tyrosine metabolism, unspecified
Genetic Disorders E70.8 Other disorders of aromatic amino-acid metabolism (Waardenburg's Syndrome, Type I)
Genetic Disorders E70.9 Disorder of aromatic amino-acid metabolism, unspecified
Genetic Disorders E72.03 Lowe's Syndrome or (Oculocerebrorenal Syndrome)
Genetic Disorders E75.23 Krabbe's Disease
Genetic Disorders E75.29 Other sphingolipidosis (Canavan Disease)
Genetic Disorders E75.3 Sphingolipidosis, unspecified
Genetic Disorders E760.1 Hurler Syndrome
Genetic Disorders E760.2 Hurler-Scheie syndrome
Genetic Disorders E760.3 Scheie's syndrome
Genetic Disorders E77.1 Defects in Glycoprotein Degradation (Mannosidosis)
Genetic Disorders E77.8 Other disorders of glycoprotein metabolism
Genetic Disorders E77.9 Disorder of glycoprotein metabolism, unspecified
Genetic Disorders E79.1 Lesch-Nyhan Syndrome
Genetic Disorders E83.00 Disorder of copper metabolism, unspecified Menkes' Syndrome (Kinky Hair Disease)
Genetic Disorders E83.01 Wilson's Disease
Genetic Disorders F84.2 Rett’s Syndrome
Genetic Disorders G31.81 Alper's Disease
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ESTABLISHED CONDITION: Genetic Disorders (Continued)
Condition Type ICD-10 Code Condition/Diagnosis
Genetic Disorders G31.82 Leigh’s Disease
Genetic Disorders G70.00 Myasthenia Gravis, without (acute) exacerbation (Familial Infantile)
Genetic Disorders G71.2 Congenital Myopathies
Genetic Disorders G91.1 Obstructive Hydrocephalus
Genetic Disorders M21.511 Acquired clawhand, right hand
Genetic Disorders M21.512 Acquired clawhand, left hand
Genetic Disorders M21.519 Acquired clawhand, unspecified hand
Genetic Disorders M21.521 Acquired clubhand, right hand
Genetic Disorders M21.522 Acquired clubhand, left hand
Genetic Disorders M21.529 Acquired clubhand, unspecified hand
Genetic Disorders M21.531 Acquired clawfoot, right foot
Genetic Disorders M21.532 Acquired clawfoot, left foot
Genetic Disorders M21.539 Acquired clawfoot, unspecified foot
Genetic Disorders M21.541 Acquired Clubfoot, Right Foot
Genetic Disorders M21.542 Acquired Clubfoot, Left Foot
Genetic Disorders M21.549 Acquired Clubfoot, Unspecified Foot (Paralytic Clubbed Foot)
Genetic Disorders M21.511 Acquired clawhand, right hand
Genetic Disorders Q03.1 Atresia of foramina of Magendie and Luschka Dandy Walker Syndrome
Genetic Disorders Q03.9 Congenital hydrocephalus, unspecified
Genetic Disorders Q04.0 Congenital malformations of corpus callosum
Genetic Disorders Q04.3 Other Reduction Deformities of Brain (Polymicrogyria)
Genetic Disorders Q72.10 Congenital Absence of Unspecified limbs
Genetic Disorders Q73.1 Phocomelia, unspecified limb(s)
Genetic Disorders Q73.2 Other Reduction Defects of Unspecified Limb(s)
Genetic Disorders Q75.9 Congenital Anomalies of Skull and Face Bone, unspecified (Goldenhar)
Genetic Disorders Q87.89 Spondyloepiphyseal dysplasia Dyggve-Melchior-Clausen Syndrome (D-M-C Dwarfism)
Genetic Disorders Q78.0 Osteogenesis Imperfecta
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ESTABLISHED CONDITION: Genetic Disorders (Continued)
Condition Type ICD-10 Code Condition/Diagnosis
Genetic Disorders Q80.8 Other congenital ichthyosis Sjogren-Larsson Syndrome
Genetic Disorders Q85.1 Tuberous Sclerosis
Genetic Disorders Q85.8 Other Phakomatosis, not elsewhere classified (Sturge-Weber Syndrome)
Genetic Disorders E78.72
Congenital malformation syndromes predominantly associated with short stature: (Prader-Willi Syndrome)
Genetic Disorders Q87.89
Congenital malformation syndromes predominantly associated with short stature: (DeLange’s Syndrome)
Genetic Disorders Q87.89
Congenital malformation syndromes predominantly associated with short stature: (Dubowitz Syndrome)
Genetic Disorders Q87.1
Congenital malformation syndromes predominantly associated with short stature: (Smith-Lemli-Opitz Syndrome)
Genetic Disorders Q87.2
Congenital malformation syndromes predominantly involving limbs: (Caudal Regression Syndrome-Sirenomelia)
Genetic Disorders Q87.2
Congenital malformation syndromes predominantly involving limbs: (Rubinstein-Taybi Syndrome)
Genetic Disorders Q87.89
Other specified congenital malformation syndromes, not elsewhere classified Zellweger/Cerebrohepatorenal Syndrome
Genetic Disorders Q90.0 Trisomy 21, nonmosaicism (meiotic nondisjunction)
Genetic Disorders Q90.1 Trisomy 21, mosaicism (mitotic nondisjunction)
Genetic Disorders Q90.2 Trisomy 21, translocation
Genetic Disorders Q90.9 Down Syndrome, Unspecified
Genetic Disorders Q91.0 Trisomy 18, nonmosaicism (meiotic nondisjunction)
Genetic Disorders Q91.1 Trisomy 18, mosaicism (mitotic nondisjunction)
Genetic Disorders Q91.2 Trisomy 18, translocation
Genetic Disorders Q91.3 Trisomy 18, Unspecified (Edward's, E3)
Genetic Disorders Q91.4 Trisomy 13, nonmosaicism (meiotic nondisjunction)
Genetic Disorders Q91.5 Trisomy 13, mosaicism (mitotic nondisjunction)
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ESTABLISHED CONDITION: Genetic Disorders (Continued)
Condition Type ICD-10 Code Condition/Diagnosis
Genetic Disorders Q91.6 Trisomy 13, translocation
Genetic Disorders Q91.7 Trisomy 13, Unspecified (Patau's, D1)
Genetic Disorders Q93.4 Deletion of short arm of chromosome 5(Cri Du Chat or Cat's Cry)
Genetic Disorders Q93.5 Other deletions of part of a chromosome (Angelman's Syndrome)
Genetic Disorders Q99.9
Other deletions from the autosomes Williams Syndrome
Genetic Disorders Q99.2 Fragile X Syndrome For Boys
Genetic Disorders R47.01 Aphasia
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ESTABLISHED CONDITION: Neurologic/Musculoskeletal
A diagnosed physical, mental, or neurobiological condition that has a high probability of resulting in developmental delay. The established condition shall be diagnosed by a health care provider and documentation shall be kept on file. Established conditions include the following: (NMAC 7.30.8.10.9 Requirements for Family Infant Toddler Early Intervention Services.)
Condition Type ICD-10 Code Condition/Diagnosis
Neurologic/Musculoskeletal A80.39 Paralysis, Other Specified
Neurologic/Musculoskeletal G06.2 Extradural and Subdural Abscess, Unspecified (Hemiplegia (Hemiparesis)
Neurologic/Musculoskeletal G11.9 Hereditary Ataxia, Unspecified (Spinocerebellar Disorders)
Neurologic/Musculoskeletal G24.1 Genetic Torsion Dystonia (Dystonia Musculorum Deformans)
Neurologic/Musculoskeletal G25.3 Myoclonus
Neurologic/Musculoskeletal G31.89 Other Specified Degenerative Diseases of Nervous System
Neurologic/Musculoskeletal G60.9 Hereditary and Idiopathic Neuropathy, Unspecified
Neurologic/Musculoskeletal G71.0 Muscular Dystrophy
Neurologic/Musculoskeletal G71.11 Myotonic Muscular Dystrophy
Neurologic/Musculoskeletal G71.12 Myotonia Congenita (Thomsen's Disease)
Neurologic/Musculoskeletal G71.2 Congenital Myopathies
Neurologic/Musculoskeletal G80.0 Spastic quadriplegic cerebral palsy
Neurologic/Musculoskeletal G80.1 Spastic Diplegic Cerebral Palsy (Congenital Diplegia, Paraplegia)
Neurologic/Musculoskeletal G80.2
Spastic hemiplegic cerebral palsy (Congenital Hemiplegia) (Infantile Postnatal NOS) (Spastic Infantile Paralysis)
Neurologic/Musculoskeletal G80.3 Athetoid cerebral palsy
Neurologic/Musculoskeletal G80.4 Ataxic cerebral palsy
Neurologic/Musculoskeletal G80.8 Other cerebral palsy
Neurologic/Musculoskeltal G80.9 Cerebral palsy, unspecified
Neurologic/Musculoskeletal G82.20 Paraplegia, unspecified Paralysis of Both Lower Limbs (Paraplegia)
Neurologic/Musculoskeletal G82.50
Quadriplegia, unspecified Paralysis of All Four Limbs (Quadriplegia, Quadriparesis,)
Neurologic/Musculoskeletal G83.0 Diplegia of upper limbs Paralysis of Both Upper Limbs (Diplegia)
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ESTABLISHED CONDITION: Neurologic/Musculoskeletal (Continued)
Condition Type ICD-10 Code Condition/Diagnosis
Neurologic/Musculoskeletal G83.10
Monoplegia of lower limb affecting unspecified side Paralysis of One Lower Limb (Monoplegia)
Neurologic/Musculoskeletal G83.20
Monoplegia of upper limb affecting unspecified side Paralysis of One Upper Limb (Monoplegia)
Neurologic/Musculoskeletal G83.9 Paralytic syndrome, unspecified
Neurologic/Musculoskeletal G93.0 Cerebral Cysts
Neurologic/Musculoskeletal G93.5 Compression of Brain
Neurologic/Musculoskeletal G93.40 Encephalopathy, unspecified
Neurologic/Musculoskeletal G93.49 Other encephalopathy
Neurologic/Musculoskeletal P11.5 Birth injury to spine and spinal cord
Neurologic/Musculoskeletal P90 Convulsions in newborn
Neurologic/Musculoskeletal P91.60 Hypoxic ischemic encephalopathy [HIE], unspecified
Neurologic/Musculoskeletal P94.2 Congenital hypotonia
Neurologic/Musculoskeletal Q00.0 Anencephaly
Neurologic/Musculoskeletal Q01.9 Encephalocele, Unspecified
Neurologic/Musculoskeletal Q02 Microcephaly
Neurologic/Musculoskeletal Q04.2 Holoprosencephaly
Neurologic/Musculoskeletal Q04.3 Other reduction deformities of brain Lissencephaly
Neurologic/Musculoskeletal Q04.6 Congenital cerebral cysts Cortical Dysplasia
Neurologic/Musculoskeletal Q05.8 Sacral spina bifida without hydrocephalus (Meningomyelocele, Meningocele)
Neurologic/Musculoskeletal Q05.9 Spina Bifida, Unspecified
Neurologic/Musculoskeletal Q07.00 Sacral Spina Bifida Without Hydrocephalus
Neurologic/Musculoskeletal Q07.01 Arnold-Chiari Syndrome with Spina Bifida
Neurologic/Musculoskeletal Q07.03 Arnold-Chiari syndrome with spina bifida and hydrocephalus
Neurologic/Musculoskeletal Q76.49 Other congenital malformations of spine, not associated with scoliosis (Sacral Agenesis)
Neurologic/Musculoskeletal Please refer to your medical professional Traumatic Brain Injury
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ESTABLISHED CONDITION: Perinatal Factors
A diagnosed physical, mental, or neurobiological condition that has a high probability of resulting in developmental delay. The established condition shall be diagnosed by a health care provider and documentation shall be kept on file. Established conditions include the following: (NMAC 7.30.8.10.9 Requirements for Family Infant Toddler Early Intervention Services.)
Condition Type ICD-10 Code Condition/Diagnosis
Perinatal Factors P07.22 Extreme immaturity of newborn, gestational age 23 completed weeks
Perinatal Factors P07.23 Extreme immaturity of newborn, gestational age 24 completed weeks
Perinatal Factors P07.24 Extreme immaturity of newborn, gestational age 25 completed weeks
Perinatal Factors P07.25 Extreme immaturity of newborn, gestational age 26 completed weeks
Perinatal Factors P07.26 Extreme immaturity of newborn, gestational age 27 completed weeks
Perinatal Factors P07.31 Preterm newborn, gestational age 28 completed weeks
Perinatal Factors P35.0 Congenital rubella syndrome
Perinatal Factors P39.9 Infection specific to the perinatal period, unspecified
Perinatal Factors P84 Other Problems with Newborns (birth asphyxia NOS, Severe)
Perinatal Factors P91.0 Neonatal cerebral ischemia
Perinatal Factors P91.1 Acquired periventricular cysts of newborn
Perinatal Factors P91.2 Neonatal cerebral leukomalacia
Perinatal Factors P91.4 Neonatal Cerebral Depression
Perinatal Factors P91.5 Neonatal Coma
Perinatal Factors P96.1 Neonatal withdrawal symptoms from maternal use of drugs of addiction
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ESTABLISHED CONDITION: Physical Impairments
A diagnosed physical, mental, or neurobiological condition that has a high probability of resulting in developmental delay. The established condition shall be diagnosed by a health care provider and documentation shall be kept on file. Established conditions include the following: (NMAC 7.30.8.10.9 Requirements for Family Infant Toddler Early Intervention Services.)
Condition Type ICD-10 Code Condition/Diagnosis
Physical Impairments C69.01 Malignant neoplasm of right conjunctiva (Retinoblastoma)
Physical Impairments C69.02 Malignant neoplasm of left conjunctiva (Retinoblastoma)
Physical Impairments H33.001 Unspecified retinal detachment with retinal break, right eye
Physical Impairments Q11.1 Other Anophthalmos
Physical Impairments Q11.2 Microphthalmia
Physical Impairments Q13.1 Absence of Iris (Aniridia)
Physical Impairments Q13.89 Other congenital malformations of anterior segment of eye
Physical Impairments Q16.1 Congenital absence, atresia and stricture of auditory canal (external)
Physical Impairments Q17.2 Microtia
Physical Impairments Q17.8 Other specified congenital anomalies of ear
Physical Impairments Q67.8 Other congenital deformities of chest
Physical Impairments Q74.9 Unspecified Congenital Malformation of Limb(s)
Diagnostic Codes Related to Family Infant Toddler (FIT) Program
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ESTABLISHED CONDITION: Sensory Abnormalities
A diagnosed physical, mental, or neurobiological condition that has a high probability of resulting in developmental delay. The established condition shall be diagnosed by a health care provider and documentation shall be kept on file. Established conditions include the following: (NMAC 7.30.8.10.9 Requirements for Family Infant Toddler Early Intervention Services.)
Condition Type ICD-10 Code Condition/Diagnosis
Sensory Abnormalities H26.009 Unspecified Infantile and Juvenile Cataract, Unspecified Eye
Sensory Abnormalities H27.03 Aphakia Bilateral
Sensory Abnormalities H27.03 Aphakia. Bilateral
Sensory Abnormalities H33.009 Unspecified Retinal Detachment with Retinal Break, Unspecified eye
Sensory Abnormalities H35.029 Exudative Retinopathy, Unspecified Eye
Sensory Abnormalities H35.119 Retinopathy of Prematurity, Stage 0, Unspecified Eye
Sensory Abnormalities H35.129 Retinopathy of Prematurity, Stage 1, Unspecified Eye
Sensory Abnormalities H35.139 Retinopathy of Prematurity, Stage 2, Unspecified Eye
Sensory Abnormalities H35.149 Retinopathy of Prematurity, Stage 3, Unspecified Eye
Sensory Abnormalities H35.159 Retinopathy of Prematurity, Stage 4, Unspecified Eye
Sensory Abnormalities H35.169 Retinopathy of Prematurity, Stage 5, Unspecified Eye
Sensory Abnormalities H35.179 Retrolental Fibroplasia, Unspecified Eye (ROP)
Sensory Abnormalities H35.52 Pignentary Retinal Distrophy (RP)
Sensory Abnormalities H35.54
Dystrophies Primarily Involving the Retinal Pigment Epithelium/Leber’s Congenital Amaurosis
Sensory Abnormalities H47.039 Optic Nerve Hypoplasia, Unspecified Eye
Sensory Abnormalities H47.20 Unspecified Optic Atrophy
Sensory Abnormalities H47.619 Cortical Blindness, Unspecified Side of the Brain (Disorders of visual cortex)
Sensory Abnormalities H53.40 Unspecified Visual Field Defects
Sensory Abnormalities H53.469 Homonomymous Bilateral Field Defects, Unspecified Side
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ESTABLISHED CONDITION: Sensory Abnormalities (continued)
Condition Type ICD-10 Code Condition/Diagnosis
Sensory Abnormalities H53.47 Heteronymous Bilateral Field Defects
Sensory Abnormalities H53.51 Achromatopsia
Sensory Abnormalities H54.7 Cortical Visual Impairment (CVI) (Unspecified Visual Loss)
Sensory Abnormalities H54.8 Blindness
Sensory Abnormalities H55.00 Unspecified nystagmus
Sensory Abnormalities H55.01 Congenital nystagmus
Sensory Abnormalities H55.09 Other Forms of Nystagmus
Sensory Abnormalities H90.3 Sensorineural Hearing Loss, Bilateral
Sensory Abnormalities H90.41 Sensorineural Hearing Loss, Unilateral, Right Ear, with Unrestricted Hearing on the Contralateral Side
Sensory Abnormalities H90.42 Sensorineural Hearing Loss, Unilateral, Left Ear, with Unrestricted Hearing on the Contralateral Side
Sensory Abnormalities H90.5 Unspecified Sensorineural Hearing Loss
Sensory Abnormalities H90.8 Mixed Conductive and Sensorineural Hearing Loss, Unspecified
Sensory Abnormalities H90.6 Mixed conductive and sensorineural hearing loss, bilateral
Sensory Abnormalities H90.71
Mixed conductive and sensorineural hearing loss, unilateral, right ear, with
unrestricted hearing on the contralateral side
Sensory Abnormalities H90.72
Mixed conductive and sensorineural hearing loss, unilateral, left ear, with unrestricted
hearing on the contralateral side
Sensory Abnormalities H91.90 Unspecified Hearing Loss, Unspecified Ear
Sensory Abnormalities H91.91 Unspecified hearing loss, right ear
Sensory Abnormalities H91.92 Unspecified hearing loss, left ear
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ESTABLISHED CONDITION: Sensory Abnormalities (continued)
Sensory Abnormalities H91.93 Unspecified hearing loss, bilateral
Sensory Abnormalities Q15.0 Congenital Glaucoma
Sensory Abnormalities Q16.9 Congenital Malformations of Ear Causing Impairment of hearing, Unspecified
Sensory Abnormalities Q89.8 Other Specified Congenital Malformations
Diagnostic Codes Related to Family Infant Toddler (FIT) Program
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MEDICAL/BIOLOGICAL RISK CONDITION: Genetic Disorders
A diagnosed physical, mental, or neurobiological condition. The biological or medical risk condition shall be diagnosed by a health care provider and documentation shall be kept on file. Biological and medical risk conditions include the following: (NMAC 7.30.8.10.9 Requirements for Family Infant Toddler Early Intervention Services.) *Questions Regarding conditions not on this list shall be directed to your FIT Manager who will work with a Department of Health Physician to determine whether a proposed condition will be recognized.
Condition Type ICD-10 Code Condition/Diagnosis
Genetic Disorders D82.1 Di George's Syndrome
Genetic Disorders E00.9 Congenital iodine-deficiency syndrome, unspecified
Genetic Disorders E70.0 Classical phenylketonuria
Genetic Disorders E70.30 Albinism, unspecified
Genetic Disorders E71.0 Maple Syrup Urine Disease
Genetic Disorders E71.110 Isovaleric Acidemia
Genetic Disorders E71.121 Methylmalonic Aciduria
Genetic Disorders E71.522 Adrenomyeloneuropathy
Genetic Disorders E72.09 Other disorders of amino-acid transport (Fanconi (-de Toni) (-Debre) Syndrome)
Genetic Disorders E72.11 Homocystinuria
Genetic Disorders E72.22 Argininosuccinic Aciduria
Genetic Disorders E72.51 Non-ketotic hyperglycinemia
Genetic Disorders E74.02 Pompe's Disease
Genetic Disorders E74.21 Galactosemia
Genetic Disorders E75.02 Tay-Sachs disease
Genetic Disorders E77.0 Defects in Post Translational Modification of Lysosomal Enzymes
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MEDICAL/BIOLOGICAL RISK CONDITION: Genetic Disorders (continued)
Condition Type ICD-10 Code Condition/Diagnosis
Genetic Disorders E75.19 Other gangliosidosis
Genetic Disorders E75.22 Gaucher’s Disease
Genetic Disorders E75.240 Niemann-Pick disease type A
Genetic Disorders E75.25 Metachromatic Leukodystrophy
Genetic Disorders E75.4 Neuronal Ceroid Lipofuscinoses
Genetic Disorders E75.01 Sandhoff disease
Genetic Disorders F19.939 Other psychoactive substance use, unspecified with withdrawal, unspecified
Genetic Disorders G11.3 Cerebellar ataxia with defective DNA repair
Genetic Disorders G12.0 Infantile Spinal Muscular Atrophy Werdnig-Hoffman Disease,
Genetic Disorders G60.9 Hypertrophic Interstitial Neuritis
Genetic Disorders G90.1 Familial Dysautonomia (Riley-Day Syndrome, HSAN III)
Genetic Disorders I67.9 Cerebrovascular Disease, Unspecified
Genetic Disorders Q79.6 Cutis laxa senilis
Genetic Disorders L94.0 Linear scleroderma
Genetic Disorders P02.8 Newborn (suspected to be) affected by other abnormalities of membranes
Genetic Disorders P35.1 Congenital cytomegalovirus infection
Genetic Disorders P35.1 Congenital cytomegalovirus infection
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MEDICAL/BIOLOGICAL RISK CONDITION: Genetic Disorders (continued)
Condition Type ICD-10 Code Condition/Diagnosis
Genetic Disorders G93.89 Other Conditions of the Brain
Genetic Disorders Q06.2 Diastematomyelia
Genetic Disorders Q26.2 Total anomalous pulmonary venous connection
Genetic Disorders Q87.40
Other specified congenital musculoskeletal deformities (Beals-Hecht Syndrome)
Genetic Disorders Q74.8 Other specified congenital malformations of limb(s) Larsen's Syndrome
Genetic Disorders Q77.0 Achondrogenesis
Genetic Disorders Q77.4 Achondroplasia
Genetic Disorders Q77.5 Diastrophic Dysplasia
Genetic Disorders Q79.9
Other osteochondrodysplasia with defects of growth of tubular bones and spine Kniest's Syndrome (Metatrophic Dwarfism II)
Genetic Disorders Q78.8 Other Specified Osteochondrodysplasia (Acrodysplasia I)
Genetic Disorders Q78.9 Osteochondrodysplasia, unspecified
Genetic Disorders Q79.6 Ehlers-Danlos Syndrome
Genetic Disorders Q80.9 Congenita Ichthyosis, Unspecified (Harlequin Fetus)
Genetic Disorders Q82.1 Xeroderma Pigmentosum
Genetic Disorders Q85.01 Other Neurofibromatosis
Genetic Disorders Q87.0
Congenital malformation syndromes predominantly affecting facial appearance Apert's Syndrome (Acrocephalosyndactyly I, ACS I)
Genetic Disorders Q87.0
Congenital malformation syndromes predominantly affecting facial appearance Saethre-Chotzen Syndrome (Chotzen's, Acrocephalosyndactyly III)
Diagnostic Codes Related to Family Infant Toddler (FIT) Program
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MEDICAL/BIOLOGICAL RISK CONDITION: Genetic Disorders (Continued)
Condition Type ICD-10 Code Condition/Diagnosis
Genetic Disorders Q87.0
Congenital malformation syndromes predominantly affecting facial appearance Robin’s Syndrome
Genetic Disorders Q87.5
Congenital malformation syndromes predominantly affecting facial appearance Oral-Facial-Digital Syndrome
Genetic Disorders Q87.89
Congenital malformation syndromes predominantly associated with short stature Noonan's Syndrome
Genetic Disorders Q87.1
Congenital malformation syndromes predominantly associated with short stature Russell (-Silver) Syndrome
Genetic Disorders Q87.2
Congenital malformation syndromes predominantly involving limbs Holt-Oram (Cardiac-Limb) Syndrome (Atriodigital Dysplasia) (Klippel-Trenaunay-Weber Syndrome) Otopalatodigital Syndrome
Genetic Disorders Q87.2
Congenital malformation syndromes predominantly involving limbs Klippel-Trenaunay-Weber Syndrome
Genetic Disorders Q87.2
Congenital malformation syndromes predominantly involving limbs Otopalatodigital Syndrome
Genetic Disorders Q87.2
Congenital malformation syndromes predominantly involving limbs Otopalatodigital Syndrome
Genetic Disorders Q87.2 Congenital malformation syndromes predominantly involving limbs VATER Syndrome
Genetic Disorders Q87.2 Congenital malformation syndromes predominantly involving limbs VATER Syndrome
Genetic Disorders Q87.3
Congenital malformation syndromes involving early overgrowth Cerebral Gigantism (Soto's Syndrome)
Genetic Disorders Q87.40 Marfan's Syndrome, Unspecified
Genetic Disorders Q87.89
Other specified congenital malformation syndromes, not elsewhere classified Langer-Giedion Syndrome (Acrodysplasia V, Klingmuller's)
Genetic Disorders Q89.8 Other Specified Congenital Malformations CHARGE Syndrome (CHARGE Association)
Diagnostic Codes Related to Family Infant Toddler (FIT) Program
21 | Page ICD-10 Codes Revised October 2015
MEDICAL/BIOLOGICAL RISK CONDITION: Genetic Disorders (Continued)
Condition Type ICD-10 Code Condition/Diagnosis
Genetic Disorders Q92.8 Other specified trisomies and partial trisomies of autosomes
Genetic Disorders Q93.7 Deletions with other complex rearrangements
Genetic Disorders Q93.81 Velo-cardio-facial Syndrome
Genetic Disorders Q96.9 Turner's syndrome, unspecified
Genetic Disorders Q97.8 Other specified sex chromosome abnormalities, female phenotype
Genetic Disorders Q98.4 Klinefelter syndrome, unspecified
Genetic Disorders Q98.8 Other specified sex chromosome abnormalities, male phenotype
Genetic Disorders Q99.9 Chromosomal Abnormality, Unspecified, (Coffin-Lowry Syndrome)
Genetic Disorders R62.7 Failure to thrive (child)
Diagnostic Codes Related to Family Infant Toddler (FIT) Program
22 | Page ICD-10 Codes Revised October 2015
MEDICAL/BIOLOGICAL RISK CONDITION: Mental/Psychosocial Disorders
A diagnosed physical, mental, or neurobiological condition. The biological or medical risk condition shall be diagnosed by
a health care provider and documentation shall be kept on file. Biological and medical risk conditions include the
following: (NMAC 7.30.8.10.9 Requirements for Family Infant Toddler Early Intervention Services.)
*Questions Regarding conditions not on this list shall be directed to your FIT Manager who will work with a Department of Health Physician to determine whether a proposed condition will be recognized.
Condition Type ICD-10 Code Condition/Diagnosis
Mental/Psychosocial Disorders F32.0
Major Depressive Affective Disorder Single Episode Unspecified (DC 0-3 R: 231 Type I Major Depression)
Mental/Psychosocial Disorders F39
Episodic Mood Disorder Unspecified (DC 0-3 R: 231 Type II Depressive Disorder)
Mental/Psychosocial Disorders F40.10 Social Phobia, Unspecified (DC 0-3 R: 220's Anxiety Disorder Disorder)
Mental/Psychosocial Disorders F40.8 Other Phobic Anxiety Disorders (DC 0-3 R: 220's Anxiety Disorder Disorder)
Mental/Psychosocial Disorders F41.1 Generalized Anxiety Disorder (DC 0-3 R: 220's Anxiety Disorder Disorder)
Mental/Psychosocial Disorders F41.9 Anxiety Disorder, unspecified (DC 0-3 R: 225 Anxiety Disorder NOS)
Mental/Psychosocial Disorders F43.10
Post-traumatic stress disorder, unspecified (DC 0-3 R: 100 Post Traumatic Stress Disorder)
Mental/Psychosocial Disorders F43.20 Adjustment disorder, unspecified (DC 0-3 R: 300 Adjustment Disorder)
Mental/Psychosocial Disorders F43.21
Adjustment disorder with depressed mood (DC 0-3 R: 210 Prolonged Bereavement/Grief Reaction)
Mental/Psychosocial Disorders F43.22 Adjustment disorder with anxiety (DC 0-3 R: 300 Adjustment Disorder)
Mental/Psychosocial Disorders F43.23
Adjustment disorder with mixed anxiety and depressed mood (DC 0-3 R: 300 Adjustment Disorder)
Mental/Psychosocial Disorders F43.24
Adjustment disorder with disturbance of conduct (DC 0-3 R: 400's Regulation Disorder of Sensory Processing)
Diagnostic Codes Related to Family Infant Toddler (FIT) Program
23 | Page ICD-10 Codes Revised October 2015
MEDICAL/BIOLOGICAL RISK CONDITION: Mental/Psychosocial Disorders (Continued)
Condition Type ICD-10 Code Condition/Diagnosis
Mental/Psychosocial Disorders F43.25
Adjustment disorder with mixed disturbance of emotions and conduct (DC 0-3 R: 150 Deprivation /Maltreatment Disorder or DC 0-3 R: 900 Relationship Disorder If PIR-GAS of 40 or below)
Mental/Psychosocial Disorders F50.00 Anorexia Nervosa, Unspecified (DC 0-3 R: 600's Feeding Behavior Disorder)
Mental/Psychosocial Disorders F50.2 Bulimia Nervosa (DC 0-3 R: 600's Feeding Behavior Disorder)
Mental/Psychosocial Disorders F50.9 Eating disorder, unspecified (DC 0-3 R: 600's Feeding Behavior Disorder)
Mental/Psychosocial Disorders F51.02 Adjustiment Insominia (DC 0-3 R: 500's Sleep Behavior Disorder)
Mental/Psychosocial Disorders F51.09
Other insomnia not due to a substance or known physiological condition (DC
0-3 R: 500's Sleep Behavior Disorder)
Mental/Psychosocial Disorders F84.8
Other Specified Pervasive Developmental Disorder (DC 0-3 R: 710 Multisystem Development Disorder)
Mental/Psychosocial Disorders F93.0
Separation anxiety disorder of childhood (DC 0-3 R: 220's Anxiety Disorder Disorder)
Mental/Psychosocial Disorders F93.9
Childhood emotional disorder, unspecified (DC 0-3 R: 240 Mixed Disorder of Emotional Expressiveness)
Mental/Psychosocial Disorders F43.29
Other childhood disorders of social functioning (DC 0-3 R: 300 Adjustment Disorder)
Mental/Psychosocial Disorders F98.21 Rumination Disorder of Infancy (DC 0-3 R: 600's Feeding Behavior Disorder)
Mental/Psychosocial Disorders F98.29
Other feeding disorders of infancy and early childhood (DC 0-3 R: 600's Feeding Behavior Disorder)
Mental/Psychosocial Disorders F98.3 PICA of Infancy and Childhood (DC 0-3 R: 600's Feeding Behavior Disorder)
Diagnostic Codes Related to Family Infant Toddler (FIT) Program
24 | Page ICD-10 Codes Revised October 2015
MEDICAL/BIOLOGICAL RISK CONDITION: Neurologic/Musculoskeletal
A diagnosed physical, mental, or neurobiological condition. The biological or medical risk condition shall be diagnosed by a health care provider and documentation shall be kept on file. Biological and medical risk conditions include the following: (NMAC 7.30.8.10.9 Requirements for Family Infant Toddler Early Intervention Services.) *Questions Regarding conditions not on this list shall be directed to your FIT Manager who will work with a Department of Health Physician to determine whether a proposed condition will be recognized.
Condition Type ICD-10 Code Condition/Diagnosis
Neurologic/Musculoskeletal A87.9 Viral meningitis, unspecified
Neurologic/Musculoskeletal C72.9 Malignant neoplasm of central nervous system, unspecified
Neurologic/Musculoskeletal G03.9 Meningitis, Unspecified
Neurologic/Musculoskeletal
G40.001
Localization-related (focal) (partial) idiopathic epilepsy and epileptic
syndromes with seizures of localized onset, not intractable, with status
epilepticus
Neurologic/Musculoskeletal
G40.009
Localization-related (focal) (partial) idiopathic epilepsy and epileptic
syndromes with seizures of localized onset, not intractable, without status
epilepticus
Neurologic/Musculoskeletal
G40.011 Localization-related (focal) (partial) idiopathic epilepsy and epileptic
syndromes with seizures of localized onset, intractable, with status epilepticus
Neurologic/Musculoskeletal
G40.019
Localization-related (focal) (partial) idiopathic epilepsy and epileptic
syndromes with seizures of localized onset, intractable, without status
epilepticus
Neurologic/Musculoskeletal
G40.111 Localization-related (focal) (partial) symptomatic epilepsy and epileptic
syndromes with simple partial seizures, not intractable, with status epilepticus
Diagnostic Codes Related to Family Infant Toddler (FIT) Program
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MEDICAL/BIOLOGICAL RISK CONDITION: Neurologic/Musculoskeletal (continued)
Condition Type ICD-10 Code Condition/Diagnosis
Neurologic/Musculoskeletal
G40.109
Localization-related (focal) (partial) symptomatic epilepsy and epileptic
syndromes with simple partial seizures, not intractable, without status
epilepticus
Neurologic/Musculoskeletal
G40.111 Localization-related (focal) (partial) symptomatic epilepsy and epileptic
syndromes with simple partial seizures, intractable, with status epilepticus
Neurologic/Musculoskeletal
G40.011
Localization-related (focal) (partial) symptomatic epilepsy and epileptic
syndromes with complex partial seizures, not intractable, with status
epilepticus
Neurologic/Musculoskeletal
G40.009
Localization-related (focal) (partial) symptomatic epilepsy and epileptic
syndromes with complex partial seizures, not intractable, without status
epilepticus
Neurologic/Musculoskeletal
G40.019 Localization-related (focal) (partial) symptomatic epilepsy and epileptic
syndromes with complex partial seizures, intractable, with status epilepticus
Neurologic/Musculoskeletal
G40.119 Localization-related (focal) (partial) symptomatic epilepsy and epileptic
syndromes with complex partial seizures, intractable, without status epilepticus
Neurologic/Musculoskeletal
G40.301 Generalized idiopathic epilepsy and epileptic syndromes, not intractable, with
status epilepticus
Neurologic/Musculoskeletal
G40.309 Generalized idiopathic epilepsy and epileptic syndromes, not intractable,
without status epilepticus
Diagnostic Codes Related to Family Infant Toddler (FIT) Program
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MEDICAL/BIOLOGICAL RISK CONDITION: Neurologic/Musculoskeletal (continued)
Condition Type ICD-10 Code Condition/Diagnosis
Neurologic/Musculoskeletal
G40.A11 Generalized idiopathic epilepsy and epileptic syndromes, intractable, with
status epilepticus
Neurologic/Musculoskeletal
G40.A19 Generalized idiopathic epilepsy and epileptic syndromes, intractable, without
status epilepticus
Neurologic/Musculoskeletal
G40.821 Other generalized epilepsy and epileptic syndromes, not intractable, with status
epilepticus
Neurologic/Musculoskeletal
G40.822 Other generalized epilepsy and epileptic syndromes, not intractable, without
status epilepticus
Neurologic/Musculoskeletal
G40.823 Other generalized epilepsy and epileptic syndromes, intractable, with status
epilepticus
Neurologic/Musculoskeletal
G40.824 Other generalized epilepsy and epileptic syndromes, intractable, without status
epilepticus
Neurologic/Musculoskeletal G40.801 Other epilepsy, not intractable, with status epilepticus
Neurologic/Musculoskeletal G40.802 Other epilepsy, not intractable, without status epilepticus
Neurologic/Musculoskeletal G40.803 Other epilepsy, intractable, with status epilepticus
Neurologic/Musculoskeletal G40.804 Other epilepsy, intractable, without status epilepticus
Neurologic/Musculoskeletal G40.812 Lennox-Gastaut Syndrome (Gastaut's Syndrome)
Neurologic/Musculoskeletal G40.901 Epilepsy, unspecified, not intractable, with status epilepticus
Diagnostic Codes Related to Family Infant Toddler (FIT) Program
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MEDICAL/BIOLOGICAL RISK CONDITION: Neurologic/Musculoskeletal (continued)
Condition Type ICD-10 Code Condition/Diagnosis
Neurologic/Musculoskeletal G40.909 Epilepsy, unspecified, not intractable, without status epilepticus
Neurologic/Musculoskeletal G40.911 Epilepsy, unspecified, intractable, with status epilepticus
Neurologic/Musculoskeletal G40.919 Epilepsy, unspecified, intractable, without status epilepticus
Neurologic/Musculoskeletal G40.B01 Juvenile myoclonic epilepsy, not intractable, with status epilepticus
Neurologic/Musculoskeletal G40.B09 Juvenile myoclonic epilepsy, not intractable, without status epilepticus
Neurologic/Musculoskeletal G40.B11 Juvenile myoclonic epilepsy, intractable, with status epilepticus
Neurologic/Musculoskeletal G40.B19 Juvenile myoclonic epilepsy, intractable, without status epilepticus
Neurologic/Musculoskeletal G72.9 Myopathy Unspecified
Neurologic/Musculoskeletal G83.89 Other Specified Paralytic Syndromes
Neurologic/Musculoskeletal G95.0 Syringomyelia and syringobulbia
Neurologic/Musculoskeletal G95.89 Other specified diseases of spinal cord
Neurologic/Musculoskeletal H55.89 Other irregular eye movements (Kinsbourne Syndrome)
Neurologic/Musculoskeletal I61.9 Nontraumatic intracerebral hemorrhage, unspecified
Neurologic/Musculoskeletal P14.0 Erb’s Paralysis due to Birth Injury
Neurologic/Musculoskeletal Q03.8 Other congenital hydrocephalus
Neurologic/Musculoskeletal Q04.6 Congenital cerebral cysts
Neurologic/Musculoskeletal Q04.8 Other Specified Congenital malformations of brain
Neurologic/Musculoskeletal R56.9 Unspecified convulsions
Diagnostic Codes Related to Family Infant Toddler (FIT) Program
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MEDICAL/BIOLOGICAL RISK CONDITION: Neurologic/Musculoskeletal (continued)
Condition Type ICD-10 Code Condition/Diagnosis
Neurologic/Musculoskeletal S14.3XXA Injury of Brachial Plexus, Initial Encounter
Neurologic/Musculoskeletal S14.3XXD Injury of Brachial Plexus, Subsequent Encounter
Neurologic/Musculoskeletal S14.3XXS Injury of Brachial Plexus, Sequela Encounter
Neurologic/Musculoskeletal
T56.0X1A Toxic Effects of Lead and Its Compounds, accidental (Sequela), Initial
Encounter
Neurologic/Musculoskeletal
T56.0X1A Toxic Effects of Lead and Its Compounds, accidental (unintentional), Initial
Encounter
Neurologic/Musculoskeletal T74.4XXA Shaken infant syndrome, initial encounter
Neurologic/Musculoskeletal T74.4XXD Shaken infant syndrome, subsequent encounter
Neurologic/Musculoskeletal T74.4XXS Shaken infant syndrome, sequela
Diagnostic Codes Related to Family Infant Toddler (FIT) Program
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MEDICAL/BIOLOGICAL RISK CONDITION: Perinatal Factors
A diagnosed physical, mental, or neurobiological condition. The biological or medical risk condition shall be diagnosed by a health care provider and documentation shall be kept on file. Biological and medical risk conditions include the following: (NMAC 7.30.8.10.9 Requirements for Family Infant Toddler Early Intervention Services.) *Questions Regarding conditions not on this list shall be directed to your FIT Manager who will work with a Department of Health Physician to determine whether a proposed condition will be recognized.
Condition Type ICD-10 Code Condition/Diagnosis
Perinatal Factors A33 Tetanus neonatorum
Perinatal Factors E80.7 Disorder of bilirubin metabolism, unspecified
Perinatal Factors O30.109
Triplet pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, unspecified trimester
Perinatal Factors O30.129 Triplet pregnancy with two or more monoamniotic fetuses, unspecified trimester
Perinatal Factors O30.199
Triplet pregnancy, unable to determine number of placenta and number of amniotic sacs, unspecified trimester
Perinatal Factors P00.9 Newborn (suspected to be) affected by unspecified maternal condition
Perinatal Factors P04.3 Newborn (suspected to be) affected by maternal use of alcohol
Perinatal Factors P04.41 Newborn (suspected to be) affected by maternal use of cocaine
Perinatal Factors P04.49 Newborn (suspected to be) affected by maternal use of other drugs of addiction
Perinatal Factors P04.9 Newborn (suspected to be) affected by maternal noxious substance, unspecified
Perinatal Factors P05.00 Newborn light for gestational age, unspecified weight
Perinatal Factors P07.01 Extremely low birth weight newborn, less than 500 grams
Perinatal Factors P07.02 Extremely low birth weight newborn, 500-749 grams
Perinatal Factors P07.03 Extremely low birth weight newborn, 750-999 grams
Perinatal Factors P07.10 Other low birth weight newborn, unspecified weight
Perinatal Factors P07.14 Other low birth weight newborn, 1000-1249 grams
Diagnostic Codes Related to Family Infant Toddler (FIT) Program
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MEDICAL/BIOLOGICAL RISK CONDITION: Perinatal Factors (continued)
Condition Type ICD-10 Code Condition/Diagnosis
Perinatal Factors P07.15 Other low birth weight newborn, 1250-1499 grams
Perinatal Factors P07.16 Other low birth weight newborn, 1500-1749 grams
Perinatal Factors P07.32 Preterm newborn, gestational age 29 completed weeks
Perinatal Factors P07.33 Preterm newborn, gestational age 30 completed weeks
Perinatal Factors P07.34 Preterm newborn, gestational age 31 completed weeks
Perinatal Factors P07.35 Preterm newborn, gestational age 32 completed weeks
Perinatal Factors P07.36 Preterm newborn, gestational age 33 completed weeks
Perinatal Factors P07.37 Preterm newborn, gestational age 34 completed weeks
Perinatal Factors P09 Abnormal findings on neonatal screening
Perinatal Factors P29.81 Cardiac arrest of newborn
Perinatal Factors P52.0 Intraventricular (nontraumatic) hemorrhage, grade 1, of newborn
Perinatal Factors P52.1 Intraventricular (nontraumatic) hemorrhage, grade 2, of newborn
Perinatal Factors P52.21 Intraventricular (nontraumatic) hemorrhage, grade 3, of newborn
Perinatal Factors P52.22 Intraventricular (nontraumatic) hemorrhage, grade 4, of newborn
Perinatal Factors P52.3 Unspecified intraventricular (nontraumatic) hemorrhage of newborn
Perinatal Factors P52.5 Subarachnoid (nontraumatic) hemorrhage of newborn
Perinatal Factors P61.9 Perinatal hematological disorder, unspecified
Perinatal Factors P70.4 Other neonatal hypoglycemia
Perinatal Factors P84 Other problems with newborn Intrauterine hypoxia
Perinatal Factors P92.9 Feeding problem of newborn, unspecified
Perinatal Factors P93.8 Other reactions and intoxications due to drugs administered to newborn
Perinatal Factors P04.8 Newborn (Suspected to be) affected by other maternal noxious substances
Diagnostic Codes Related to Family Infant Toddler (FIT) Program
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MEDICAL/BIOLOGICAL RISK CONDITION: Physical Impairments
A diagnosed physical, mental, or neurobiological condition. The biological or medical risk condition shall be diagnosed by a health care provider and documentation shall be kept on file. Biological and medical risk conditions include the following: (NMAC 7.30.8.10.9 Requirements for Family Infant Toddler Early Intervention Services.) *Questions Regarding conditions not on this list shall be directed to your FIT Manager who will work with a Department of Health Physician to determine whether a proposed condition will be recognized.
Condition Type ICD-10 Code Condition/Diagnosis
Physical Impairments M06.9 Rheumatoid arthritis, unspecified
Physical Impairments M41.20 Other idiopathic scoliosis, site unspecified
Physical Impairments Q68.0 Congenital Torticollis
Physical Impairments Q35.9 Cleft palate, unspecified
Physical Impairments Q36.0 Cleft Lip, Bilateral
Physical Impairments Q36.9 Cleft Lip, unilateral
Physical Impairments Q37.9 Cleft Palate with Cleft Lip
Physical Impairments Q71.60 Lobster-claw hand, unspecified hand
Physical Impairments Q71.61 Lobster-Claw Right Hand
Physical Impairments Q71.62 Lobster-Claw Left Hand
Physical Impairments Q71.63 Lobster-Claw Hand, Bilateral
Physical Impairments Q73.8 Other Reduction Defects of Unspecified Limbs
Physical Impairments Q74.3 Arthrogryposis multiplex congenita
Physical Impairments Q74.9 Unspecified Congenital Malformation of Limb(s)
Physical Impairments Q75.0 Craniosynostosis
Physical Impairments Q75.4 Mandibulofacial Dysostosis (Franschetti-Klein Syndrome)
Physical Impairments Q79.0 Congenital Diaphragmatic Hernia
Physical Impairments Q79.3 Gastronschisis
Physical Impairments Q79.4 Prune Belly Syndrome
Physical Impairments Q79.8 Other Congenital Malformations of Musculoskeletal System Poland’s Syndrome
Physical Impairments Q87.0
Congenital Malformation Syndrome Predominantly Affecting Facial Appearance Goldenhar’s Syndrome (Oculouriculoverterbral Dysplasia)0
Diagnostic Codes Related to Family Infant Toddler (FIT) Program
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MEDICAL/BIOLOGICAL RISK CONDITION: Sensory Abnormalities
A diagnosed physical, mental, or neurobiological condition. The biological or medical risk condition shall be diagnosed by a health care provider and documentation shall be kept on file. Biological and medical risk conditions include the following: (NMAC 7.30.8.10.9 Requirements for Family Infant Toddler Early Intervention Services.) *Questions Regarding conditions not on this list shall be directed to your FIT Manager who will work with a Department of Health Physician to determine whether a proposed condition will be recognized.
Condition Type ICD-10 Code Condition/Diagnosis
Sensory Abnormalities F98.4 Stereotyped Movement Disorder (Spasmus Nutans)
Sensory Abnormalities H02.401 Unspecified ptosis of right eyelid
Sensory Abnormalities H02.402 Unspecified ptosis of left eyelid
Sensory Abnormalities H02.403 Unspecified ptosis of bilateral eyelids
Sensory Abnormalities H50.00 Esotropia Unspecified
Sensory Abnormalities H50.10 Exotropia Unspecified
Sensory Abnormalities H50.811 Duane’s Syndrome, Right Eye
Sensory Abnormalities H50.812 Duane’s Syndrome, Left Eye
Sensory Abnormalities H50.89 Other Specified Strabismus
Sensory Abnormalities H51.9 Unspecified disorder of binocular movement
Sensory Abnormalities H52.00 Hypermetropia, unspecified eye
Sensory Abnormalities H52.01 Hypermetropia, right eye
Sensory Abnormalities H52.02 Hypermetropia, left eye
Sensory Abnormalities H52.03 Hypermetropia, bilateral
Sensory Abnormalities H52.13 Myopia, Bilateral
Sensory Abnormalities H52.10 Myopia, unspecified eye
Diagnostic Codes Related to Family Infant Toddler (FIT) Program
33 | Page ICD-10 Codes Revised October 2015
MEDICAL/BIOLOGICAL RISK CONDITION: Sensory Abnormalities (Continued)
Condition Type ICD-10 Code Condition/Diagnosis
Sensory Abnormalities H52.11 Myopia, right eye
Sensory Abnormalities H52.12 Myopia, left eye
Sensory Abnormalities H53.001 Unspecified amblyopia, right eye
Sensory Abnormalities H53.002 Unspecified amblyopia, left eye
Sensory Abnormalities H53.003 Unspecified amblyopia, bilateral
Sensory Abnormalities H53.009 Unspecified Amblyopia
Sensory Abnormalities H53.8 Other visual disturbances
Sensory Abnormalities H53.9 Unspecified Visual Disturbance
Sensory Abnormalities H53.9 unspecified visual loss (Delayed Visual Maturation)
Sensory Abnormalities H65.20 Chronic serous otitis media, unspecified ear
Sensory Abnormalities H65.21 Chronic serous otitis media, right ear
Sensory Abnormalities H65.22 Chronic serous otitis media, left ear
Sensory Abnormalities H65.23 Chronic serous otitis media, bilateral
Sensory Abnormalities H90.2 Conductive hearing loss, unspecified
Sensory Abnormalities Q10.0 Congenital ptosis
Sensory Abnormalities Q17.9 Congenital malformation of ear, unspecified
Diagnostic Codes Related to Family Infant Toddler (FIT) Program
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ENVIRONMENTAL RISK FACTORS: Personal History Presenting Hazard to Health
A presence of adverse family factors in the child’s environment that increases the risk for developmental delay in children. Eligibility determination shall be made using the Environmental Risk Assessment (ERA) tool approved by the FIT program. (NMAC 7.30.8.10.9 Requirements for Family Infant Toddler Early Intervention Services.)
Condition Type ICD-10 Code Condition/Diagnosis
Personal History Presenting Hazard to Health Z77.011 Contact with and (suspected) exposure to lead
Personal History Presenting Hazard to Health Z77.9
Other contact with and (suspected) exposures hazardous to health
Personal History Presenting Hazard to Health Z91.410
Personal history of adult physical and sexual abuse (e.g., sexual abuse or rape)
Personal History Presenting Hazard to Health Z91.412 Personal history of adult neglect (e.g., neglect)
Personal History Presenting Hazard to Health Z91.49
Other personal history of psychological trauma, not elsewhere classified
Personal History Presenting Hazard to Health Z77.9 Other specified personal risk factors, not elsewhere classified
ENVIRONMENTAL RISK FACTORS: Family History of Certain Chronic Disabling Diseases
A presence of adverse family factors in the child’s environment that increases the risk for developmental delay in children. Eligibility determination shall be made using the Environmental Risk Assessment (ERA) tool approved by the FIT program. (NMAC 7.30.8.10.9 Requirements for Family Infant Toddler Early Intervention Services.)
Condition Type ICD-10 Code Condition/Diagnosis
Family History of Certain Chronic Disabling Diseases Z81.8
Family history of other mental and behavioral disorders
Family History of Certain Chronic Disabling Diseases Z82.0
Family history of epilepsy and other diseases of the nervous system
Family History of Certain Chronic Disabling Diseases Z82.69
Family history of other diseases of the musculoskeletal system and connective tissue
Diagnostic Codes Related to Family Infant Toddler (FIT) Program
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ENVIRONMENTAL RISK FACTORS: Family History of Certain Other Specific Conditions
A presence of adverse family factors in the child’s environment that increases the risk for developmental delay in children. Eligibility determination shall be made using the Environmental Risk Assessment (ERA) tool approved by the FIT program. (NMAC 7.30.8.10.9 Requirements for Family Infant Toddler Early Intervention Services.)
Condition Type ICD-10 Code Condition/Diagnosis
Family History of Certain Other Specific Conditions Z81.0 Family History of Intellectual Disabilities
ENVIRONMENTAL RISK FACTORS: Family History of Other Conditions
A presence of adverse family factors in the child’s environment that increases the risk for developmental delay in children. Eligibility determination shall be made using the Environmental Risk Assessment (ERA) tool approved by the FIT program. (NMAC 7.30.8.10.9 Requirements for Family Infant Toddler Early Intervention Services.)
Condition Type ICD-10 Code Condition/Diagnosis
Family History of Other Conditions Z82.1 Family history of blindness and visual loss
Family History of Other Conditions Z82.2 Family history of deafness and hearing loss
Family History of Other Conditions Z82.79
Family history of other congenital malformations, deformations and chromosomal abnormalities
Family History of Other Conditions Z84.89 Family history of other specified conditions
ENVIRONMENTAL RISK FACTORS: Health Supervision of Infant or Child
A presence of adverse family factors in the child’s environment that increases the risk for developmental delay in children. Eligibility determination shall be made using the Environmental Risk Assessment (ERA) tool approved by the FIT program. (NMAC 7.30.8.10.9 Requirements for Family Infant Toddler Early Intervention Services.)
Condition Type ICD-10 Code Condition/Diagnosis
Health Supervision of Infant or Child Z76.2
Encounter for health supervision and care of other healthy infant and child (e.g., supervision of healthy infant in cases of socioeconomic adverse condition at home)
Diagnostic Codes Related to Family Infant Toddler (FIT) Program
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ENVIRONMENTAL RISK FACTORS: Housing, Household, and Economic Circumstances
A presence of adverse family factors in the child’s environment that increases the risk for developmental delay in children. Eligibility determination shall be made using the Environmental Risk Assessment (ERA) tool approved by the FIT program. (NMAC 7.30.8.10.9 Requirements for Family Infant Toddler Early Intervention Services.)
Condition Type ICD-10 Code Condition/Diagnosis
Housing, Household, and Economic Circumstances Z59.0 Homelessness (e.g., Social migrants, Transients)
Housing, Household, and Economic Circumstances Z59.1
Inadequate housing (e.g., Lack of heating, Restriction of space)
Housing, Household, and Economic Circumstances Z59.6 Low income (e.g., Economic problem, Poverty)
Housing, Household, and Economic Circumstances Z59.8
Other problems related to housing and economic circumstances
Housing, Household, and Economic Circumstances Z59.9 Unspecified housing or economic circumstance
Housing, Household, and Economic Circumstances Z74.2
Need for assistance at home and no other household member able to render care
ENVIRONMENTAL RISK FACTORS: Other Family Circumstances
A presence of adverse family factors in the child’s environment that increases the risk for developmental delay in children. Eligibility determination shall be made using the Environmental Risk Assessment (ERA) tool approved by the FIT program. (NMAC 7.30.8.10.9 Requirements for Family Infant Toddler Early Intervention Services.)
Condition Type ICD-10 Code Condition/Diagnosis
Other Family Circumstances Z62.898
Other specified problems related to upbringing (e.g., Problem concerning
adopted or foster child)
Other Family Circumstances Z63.6
Dependent relative needing care at home (e.g., Care of sick or handicapped person in family or household)
Other Family Circumstances Z63.72 Alcoholism and drug addiction in family
Other Family Circumstances Z62.891 Other specified problems related to primary support group
Other Family Circumstances Z69.010
Encounter for mental health services for perpetrator of parental child abuse Counseling for parent-child problem, unspecified
Diagnostic Codes Related to Family Infant Toddler (FIT) Program
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ENVIRONMENTAL RISK FACTORS: Other Family Circumstances (Continued)
Condition Type ICD-10 Code Condition/Diagnosis
Other Family Circumstances Z69.020
Encounter for mental health services for victim of parental child abuse Counseling for victim of child abuse
Other Family Circumstances Z69.11
Encounter for mental health services for victim of spousal or partner abuse (Counseling for victim of spousal and partner abuse)
Other Family Circumstances Z69.12
Encounter for mental health services for perpetrator of spousal or partner
abuse (Counseling for perpetrator of spousal and partner abuse)
Other Family Circumstances Z69.020
Other specified counseling (Counseling for marital and partner problems, unspecified)
ENVIRONMENTAL RISK FACTORS: Other Psychosocial Circumstances
A presence of adverse family factors in the child’s environment that increases the risk for developmental delay in children. Eligibility determination shall be made using the Environmental Risk Assessment (ERA) tool approved by the FIT program. (NMAC 7.30.8.10.9 Requirements for Family Infant Toddler Early Intervention Services.)
Condition Type ICD-10 Code Condition/Diagnosis
Other Psychosocial Circumstances Z13.4 Encounter for screening for certain developmental disorders in childhood
Other Psychosocial Circumstances Z60.3
Acculturation difficulty (e.g., Cultural deprivation, Social isolation or persecution)
Other Psychosocial Circumstances Z63.9 Problem related to primary support group, unspecified
Other Psychosocial Circumstances Z65.3 Problems related to other legal circumstances (e.g., Imprisonment)
Other Psychosocial Circumstances Z65.8
Other specified problems related to psychosocial circumstances (e.g., Life circumstance problems)
Other Psychosocial Circumstances Z64.4
Other specified problems related to psychosocial circumstances (Interpersonal problems, not elsewhere classified)
Other Psychosocial Circumstances Z65.9 Problem related to unspecified psychosocial circumstances