ICD-9 CM CODES - Developmental disability, early ...

1 Improving Developmental Screening Practices for Young Children ICD-9 CM CODES NERVOUS SYSTEM Unspecified encephalopathy Unspec condition of brain Unspec d/o of nervous system Microcephaly Congenital hydrocephalus Other specified anomalies of the brain (megalencephaly) Unspecified anomaly of brain, spinal cord, & nervous system MOTOR DISTURBANCES Coordination d/o- (clumsiness syndrome, dyspraxia, specific motor dev d/o) 343 Infantile cerebral palsy Diplegic Hemiplegic Quadriplegic Monoplegic Infantile hemiplegia Other specified infantile cerebral palsy Unspecified CP Abnormal gait, ataxic, staggering, paraplegic Dyspraxia/lack of coordination- muscular Unspecified d/o of ligament, muscle (hyper-,hypotonia Benign essential tremor, familial tremor Tremor, NOS Tics Stereotyped Repetitive Movements Tic disorder.)

2 Unspecified Transient tic d/o- childhood Chronic motor tic disorder Tourette s d/o HYPERKINETIC SYNDROME OF CHILDHOOD (314) Attn defic nonhyperact. With hyperactivity Hyperkinesis w/development. delay Hyperkinetic synd NOS LEARNING DISORDERS Reading d/o, unspecified Specific arithmetical d/o Other specific learning disorder Mixed Developmental d/o Other specified delays Unspecified delays Academic underachievement Other (acalculia, agnosia, apraxia, agraphia)-NOS COMMUNICATION DISTURBANCE Other symbolic dysfunction ( apraxia) Abnl. auditory perception (CAPD) Pseudobulbar palsy Developmental DELAY/DISORDER Delayed milestones Other spec.

3 Delays in dev. Unspecified delays in dev. Skin hypersensitivity Hyperacusis BEHAVIORAL DIAGNOSES Mood swings Organic affective disorder Anxiety NOS Overanxious disorder Misery & unhappiness d/o Sensitive, shyness&social withdrawal disorder Shyness d/o of childhood Selective mutism Other or mixed emotional Oppositional disorder Academic underachiev. d/o Unspecified emotional Eating disorder, unspecified Brief depressive reaction Prolonged depressive reaction Adj. Rxn. w/predominant disturbance of other emotions Separation anxiety disorder Spec.

4 Academic or work inhibition Adjust react. w/ anxious mood Adjustment reaction with mixed emotional features Other W/ predom disturb of conduct Other specified adjustment reactions Unspecified adjust. reaction Depression-NOS Undersocialized conduct d/o aggressive type (Aggressive outburst,anger rxn, bullying) Conduct D/0-unaggressive (temper tantrums,stealing) type Socialized conduct disorder DO of impulse con/not elsewhere Intermittent explosive d/o Mixed disturb. of conduct& emotions Other- not elsewhere classified Disruptive behavior, NOS OTHER Enuresis Encopresis Transient d/o of initiating or maintaining sleep Phase shift disruption of sleep-wake cycle Night terrors Nightmares Underweight Unspecified lack of normal physiological development Failure to thrive Short stature Disorders of sensory systems Congenital deafness NOS Deafness,sensorineural 369 Vision impairment/blind V- CODES Borderline intelligence Screening- Developmental problems Suspect problem.

5 Not demonstrated Commonly Used Diagnostic CODES Use generic terms to avoid future denials for treatment, such as: Developmental Delay Academic Inhibition (school problems) Developmental Coordination Disorder Other Speech Disturbance Disturbance of Conduct Improving Developmental Screening Practices for Young Children CPT CODES (PROCEDURE CODES FOR SCREENING) 96110 Developmental Screening 96111 Extended Developmental Screening* 96114 Neurobehavioral status exam** 99202-99205 E&M**, Office Procedural CODES , new patient 99212-99215 E&M**, Office Procedural CODES , return patient 99420 Administration and interpretation of health risk assessment** * Applies to narrow/follow-up measures such as autism screening ** Usually results in higher reimbursement and should be reserved for standardized Developmental screening as opposed to checklists, informal observation, etc.

6 ** E&M indicates evaluation and management ** Behavior screening A far more complete guide to CPT CODES for Developmental and behavioral pediatrics can be found in: The Classification of Child and Adolescent Mental Diagnoses in Primary Care: Diagnostic and Statistical Manual for Primary Care (DSM-PC) Child Available from or