NEW YORK STATE EARLY INTERVENTION PROGRAM Diagnosed Conditions With a High Probability of Developmental Delay

A child diagnosed with any of the conditions on this list is automatically eligible for the Early Intervention (EI) program. EI evaluators will perform a complete multidisciplinary evaluation. The evaluation results along with other information about the child and family will be used to create an Individualized Family Service Plan for the child. Anyone can refer a child to EI by calling 311 and asking for Early Intervention, or by completing the Early Intervention referral form and selecting “Early Intervention” under “Reason for Referral.”

Diagnosed Conditions With a High Probability of ICD-10 Codes Developmental Delay Miscellaneous conditions

Q35.1, Q35.3, Q35.5, Q35.7, Q35.9, Q36.0, Q36.1, Q36.9, Q37.0, Q37.1, Cleft palate (hard, soft or both) and/or lip (prior to surgical correction) or uvula Q37.2, Q37.3, Q37.4, Q37.5, Q37.8, Q37.9

([WUHPHO\ORZELUWKZHLJKW OHVVWKDQJUDPV GXULQJWKHàUVWPRQWKVRIDJH P07.01, P07.02, P07.03

&HUHEUDOSDOV\XQVSHFLàHGRWKHUDWD[LFDWKHWRLGVSDVWLFKHPLSOHJLFVSDVWLFGLSOHJLFRU G80.0, G80.1, G80.2, G80.3, G80.4, spastic quadriplegic G80.8, G80.9 Genetic syndromes or congenital problems

Angelman syndrome (AS) Q93.5

CHARGE syndrome Q87.8

Tyrosinemia E70.21

Other disorders of tyrosine metabolism E70.29

Disorders of tryptophan metabolism E70.5

Other disorders of aromatic amino acid metabolism E70.8

Alport syndrome Q87.81

Barth syndrome (BTHS) E78.71

Smith-Lemli-Opitz (SLO) syndrome E78.72

Trisomy 13 Q91.4, Q91.5, Q91.6, Q91.7

Trisomy 18 Q91.0, Q91.1, Q91.2, Q91.3

Trisomy 21 Q90.0, Q90.1, Q90.2, Q90.9

Fragile X chromosome Q99.2

Prader-Willi syndrome Q87.1

Fetal alcohol syndrome (dysmorphic) Q86.0 Congenital malformations

Congenital malformation syndromes predominantly involving limbs Q87.2

Congenital malformation syndromes involving early overgrowth Q87.3

Congenital malformation syndromes with other skeletal changes Q87.5

2WKHUVSHFLàHGFRQJHQLWDOPDOIRUPDWLRQV\QGURPHVQRWHOVHZKHUHFODVVLàHG Q87.89

0XOWLSOHFRQJHQLWDOPDOIRUPDWLRQVQRWHOVHZKHUHFODVVLàHG Q89.7

2WKHUVSHFLàHGFRQJHQLWDOPDOIRUPDWLRQV Q89.8

Ectrodactyly (split-hand malformation) Q71.61, Q71.62, Q71.63

Q71.899, Q71.90, Q72.899, Q73.0, Other reduction defect or absence of the upper or lower limb Q73.8, Q74.8

Arthrogryposis multiplex congenita (AMC) Q74.3

Phocomelia Q73.1

Q05.0, Q05.1, Q05.2, Q05.3, Q05.4, 6SLQDELàGD Q05.5, Q05.6, Q05.7, Q05.8, Q05.9 Muscular problems

Congenital hereditary muscular dystrophy G71.0

Myotonic muscular dystrophy G71.11

Congenital myopathies G71.2

2WKHUVSHFLàHGP\RSDWKLHV G72.89

8QVSHFLàHGP\RSDWK\ G72.9

Werdnig-Hoffman disease or infantile spinal muscular atrophy (SMA) type 1 G12.0

Spinal cord injury S14, S24, S34 Epilepsies

Localization-related focal partial idiopathic epilepsy and epileptic syndromes with seizures G40.009 of localized onset, not intractable, without status epilepticus

Epileptic spasms, not intractable, with or without status epilepticus G40.821, G40.822

Epileptic spasms, intractable, with or without status epilepticus G40.823, G40.824

(SLOHSV\XQVSHFLàHGQRWLQWUDFWDEOHZLWKRXWVWDWXVHSLOHSWLFXV G40.909 Central nervous system (CNS) malformations or dysfunction

Microcephaly Q02

Hydrocephalus, communicating or obstructive G91.0, G91.1, Q03.1, Q03.8, Q03.9

Cystic periventricular leukomalacia P91.2

Newborn intraventricular hemorrhage (IVH), grade IV P52.22

Kernicterus P57.8, P57.9

Multiple anomalies of the brain: congenital cerebral cyst, macrocephaly, megalencephaly, Q01.0, Q01.1, Q01.2, Q01.8, Q01.9, porencephaly, encephalocele, arhinencephaly or holoprosencephaly (HPE), lissencephaly, Q04.1, Q04.2, Q04.3, Q04.4, septo-optic dysplasia, or reduction deformities of brain Q04.5, Q04.6, Q04.8

Agenesis of the corpus callosum (ACC) Q04.0

$UQROG&KLDULPDOIRUPDWLRQZLWKVSLQDELàGDDQGRUK\GURFHSKDOXV Q07.01, Q07.02, Q07.03 Visual and ocular problems

H54.0, H54.1, H54.10, H54.2, H54.3, Blindness or low vision, one or both eyes H54.4, H54.5, H54.6, H54.7, H54.8

Optic disc coloboma H47.311, H47.312, H47.313, H47.319

Optic nerve hypoplasia H47.033, H47.039

Other disorders of the optic nerve H47.099

Albinism E70.30

Visual deprivation nystagmus H55.03

Microphthalmos Q11.2

Absence of iris Q13.1

Congenital corneal malformations Q13.4

Congenital malformation of the optic disc Q14.2

8QVSHFLàHGEDFNJURXQGUHWLQRSDWK\ H35.00

H35.151, H35.152, H35.153, H35.159, Retinopathy of prematurity, stage 4 or 5, in one or both eyes H35.161, H35.162, H35.163, H35.169, H35.179

Dystrophies primarily involving the sensory retina or retinal pigment epithelium H35.53, H35.54 Hearing loss

H90.0, H90.11, H90.12, H90.2, H90.3, H90.41, H90.42, H90.5, H90.6, Conductive, sensorineural, or mixed conductive and sensorineural hearing loss H90.71, H90.72, H90.8, H90.A11, H90.A12, H90.A21, H90.A22, H90.A31, H90.A32, H91.3

Q16.0, Q16.1, Q16.3, Q16.4, Q16.5, Congenital malformation of the ear with hearing impairment Q16.9 Developmental, behavioral and emotional conditions

'\VSUD[LD VSHFLàFGHYHORSPHQWDOGLVRUGHURIPRWRUIXQFWLRQ F82

Autistic disorder F84.0, PDD F84.8, PDD F84.9

Asperger’s syndrome F84.5

Post-traumatic stress disorder F43.10, F43.12

Separation anxiety disorder of childhood F93.0

Other childhood emotional disorders F93.8, F93.9

Reactive attachment disorder of childhood F94.1

Other childhood disorders of social functioning F94.8

$WWHQWLRQGHàFLWK\SHUDFWLYLW\GLVRUGHU $'+' FRPELQHGW\SH F90.2

8QVSHFLàHGEHKDYLRUDODQGHPRWLRQDOGLVRUGHUVZLWKRQVHWXVXDOO\RFFXUULQJLQFKLOGKRRG and adolescence F98.9

6.18