Coding Intellectual Disabilities
Intellectual disability is a term used when there are limits to the ability to learn at an expected level and function in daily life. Levels of intellectual disability differ greatly in children. A child with an intellectual disability might have a hard time letting others know what their wants and needs are and taking care of themselves.
An intellectual disability could cause a child to learn and develop more slowly than other children of the same age and it could take longer for a child to learn to speak, walk, dress, or eat without help, and they could have trouble learning in school. An intellectual disability can be caused by a problem that starts any time before a child turns 18 years old or even before birth. Some of the most known causes of an intellectual disability—like Down syndrome, fetal alcohol syndrome, fragile X syndrome, genetic conditions, birth defects, and infections—happen before birth. Others happen while a baby is born or soon after birth. Still, other causes of intellectual disability do not occur until a child is older; these might include serious head injury, stroke, or certain infections.
To code for these types of intellectual disorders you would first code any associated physical or developmental disorders and then follow with the code for the intellectual disorder. Intellectual disabilities are coded by stage, such as mild, moderate, severe, and profound. The stage is determined by Intelligence Quotient (IQ) levels. There are other pervasive developmental disorders as well that include autistic disorders, Asperger’s syndrome, and such.
For patients suffering from behavioral and emotional disorders with onset usually occurring in childhood and adolescence the conditions are captured in F90-F98.
Attention-deficit hyperactivity disorder (ADHD) is a problem with inattentiveness, over-activity, impulsivity, or a combination. For these problems to be diagnosed as ADHD, they must be out of the normal range for a child’s age and development. Coding for ADHD is broken down as to whether the condition is predominately hyperactive, inattentive, or the combined type.
Q: A father brings his son to the doctor because he has been getting in trouble in school for his behavior. He is not paying attention or following the instructions. He is constantly losing his pencil and forgetting to bring in his homework. After evaluating the child, the provider diagnoses him with attention deficit hyperactivity disorder (ADHD), predominately inattentive type, and sends the patient for a consultation with a psychiatrist to see if medication can help. What is the ICD-10-CM code for this encounter?
A: F90.0 Rationale: The patient is diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), predominately inattentive type. In our ICD-10-CM codebook Alphabetic Index, look for Disorder (of)/attention deficit hyperactivity (adolescent) (adult) (child)/inattentive/ type F90.0. As always we want to verify code selection in the Tabular List.
Reference: FY 2023 ICD-10-CM codebook
