Rhode Island Early Intervention ICD-9 and ICD-10 CODES ESTABLISHED CONDITIONS LIST AND SIGNIFICANT DEVELOPMENTAL DELAY All children diagnosed with established conditions that have a high probability of resulting in developmental delay, are eligible for early intervention services until the child’s third birthday, unless a change in the status of a diagnosis or condition resolves with medical/surgical treatment. Diagnosis must be made by a physician or other appropriately licensed professional and documentation of medical diagnosis is required. If a medical diagnosis or condition is not included in the RI Early Intervention Established Conditions List and it is a condition associated with developmental delay, approval for its use as Single Established Condition by the Lead Agency is required. Conditions listed with an asterisk * may be used only in determining initiial eligibility and require eligibilty to be re-determined in 1 year. These children must meet the criteria for Significant Developmental Delay at that time or be diagnosed with another qualifying condition. Conditions include but are not limited to the following listing. ICD-9 codes with an x indicate that the condition has several types. Additional digits for the specific type are required. SENSORY CONDITIONS CENTRAL NERVOUS SYSTEM DISORDERS (Continued) BLINDNESS 742.2 Q04.3 Lissencephaly 369.00 H54.0 Blindness, both eyes 322.9 G03.9 Meningitis with negative long-term effects 369.60 H54.40 Blindness, one eye 742.1 Q02 Microcephaly 377.75 H47.619 Cortical Blindness/Cortical Vision Impairment 292.0 *P96.1 Neonatal Abstinence Syndrome 377.10 H47.20 Optic Nerve Atrophy 742.2 Q04.3 Polymicrogyria 362.21 *H35.109 Retinopathy of Prematurity 780.39 R56.9 Seizure disorder (repetitive, recurrent) LOW VISION 345.60 G40.xxx Spasms, infantile 369.20 H54.2 Low vision, both eyes 741.00 Q05.4 Spina bifida with hydrocephalus (20/70 best acuity with correction) 741.90 Q05.8 Spina bifida without mention of hydrocephalus 369.70 *H54.50 Low vision, one eye 767.4 P11.5 Spinal Cord Injury at birth HEARING LOSS (permanent) 952.9 S14.109A Spinal Cord Injury not at birth 389.9 H91.93 Hearing impairment, bilateral 741.90 Q05.8 Spinal Lipomeningocele 389.9 H91.90 Hearing impairment, unilateral 759.6 Q85.8 Sturge-Weber disease 389.12 H90.5 Neural hearing loss/auditory neuropathy CHROMOSOMAL DISORDERS CANCERS 429.3 Q93.4 Cat Cry Syndrome (Cri-du-Chat) 199.1 C80.1 Cancer, Other (not included on this list) 758.x Q90.xx Chromosomal Anomaly (including Trisomies, 208.90 C91-95x Leukemia Deletions, Duplications, Translocations, 202.80 C83.7x Lymphoma Inversions, Rings and Isochromosome) 191.9 C71.9 Malignant neoplasm of brain Exceptions: Klinfelter’s Syndrome, Turner Syndrome) 189.0 C64.9 Malignant neoplasm of kidney 759.8 Q87.1 Cornelia De Lange Syndrome 170.9 C41.9 Osteosarcoma 758.0 Q90.9 Down Syndrome 171.4 C49.3 Rhabdomyosarcoma 759.83 Q99.2 Fragile X Syndrome CARDIAC CONDITIONS 759.81 Q87.1 Prader-Willi Syndrome 745.69 Q21.2 Atrioventricular canal defect 758.33 Q93.88 Smith-Magenis Syndrome 425.x Cardiomyopathy METABOLIC DISORDERS 747.1 Q25.1 Coarctation of the aorta 270.6 E72.20 Disorders of urea cycle metabolism 416.0 I27.0 Hypertension, pulmonary 270.9 E72.9 Amino acid metabolism disorder 746.7 Q23.4 Hypoplastic left heart syndrome 272.6 E88.1 Congenital lipodystrophy 746.9 Q24.9 Major cardiac anomaly, other (not included on this list) 271.1 *E74.21 Galactosemia 745.2 Q21.3 Tetralogy of Fallot 330.1 E75.19 Gangliosidosis 745.10 Q20.3 Transposition of great vessels 271.0 E74.00 Glycogen storage disease CENTRAL NERVOUS SYSTEM DISORDERS 277.5 E76.01 Hurler Syndrome 759.89 Q04.0 Aicardi syndrome 275.3 E83.39 Hypophosphatasia 740.0 Q00.0 Anencephaly 277.85 E71.310 LCHAD (Long Chain Acyl CoA Dehydrogenase Deficiency) 334.8 G11.3 Ataxia-Telangiectasia 270.3 *E71.0 Maple syrup urine disease/Methylmalonic acidemia 742.4 Q04.8 Brain Sclerosis 759.8 E83.09 Menkes Syndrome 335.22 G12.22 Bulbar palsy 277.5 E76.3 Mucopolysaccharidosis 742.4 Q04.8 Cerebral atrophy, congenital 271.8 E74.8 Other specified disorders of carbohydrate transport 343.9 G80.x Cerebral palsy and metabolism 436.9 I61.9 Cerebrovascular accident (CVA) 270.7 E72.3 Propionic acidemia 742.4 Q04.6 Congenital Schizencephaly 757.1 Q87.1 Sjogren-Larsson Syndrome 742.3 Q03.1 Dandy-Walker malformation 330.1 E75.02 Tay-Sachs disease 343.0 G80.1 Diplegia SKELETAL DISORDERS 323.9 G04.90 Encephalitis 714.30 M08.00 Arthritis, juvenile rheumatoid 742.0 Q01.9 Encephalocele 754.89 Q74.3 Arthrogryposis 348.30 G93.4 Encephalopathy 757.39 Q82.8 Beals Syndrome 345.90 G40.9xx Epilepsy 755.59 Q74.0 Cleidocranial Dysostosis 342.90 G81.90 Hemiparesis/Hemiplegia 756.0 Q75.0 Craniostenosis 742.2 Q04.02 Holoprosencephaly/Hypoplasia of the brain 756.0 Q75.9 Crouzon's Syndrome 742.3 Q04.3 Hydranencephaly 352.6 Q87.0 Mobius sequence 345.60 G40.8xx Hypsarrhythmia 756.0 Q75.0 Nager-de Reynier Syndrome 772.13 P52.21 Intraventricular hemorrhage (grade 3 ) 756.51 Q78.0 Osteogenesis imperfecta 772.14 P52.22 Intraventricular hemorrhage (grade 4) 755.30 Q68.8 Proximal Focal Femoral Deficiency (PFFD w/fibula hemimelia) 330.0 E75.25 Leukodystrophy/Canavan disease 754.89 *Q68.1 Radial Club Hand October 2015 ICD-9/ICD10 Codes Established Conditions List and Developmental Delay Rev Feb 2016 ICD-9 and ICD-10 CODES ESTABLISHED CONDITIONS LIST OTHER DISORDERS OTHER DISORDERS (Continued) 755.4 Q73.0 Absence of limb 771.0 P35.00 Rubella, congenital 756.4 Q77.4 Achondroplasia 754.2 M41.00 Scoliosis (congenital, severe) 658.8 *P02.8 ADAM Complex 754.1 *Q68.0 Torticollis, congenital 042 B20 AIDS 771.2 P37.1 Toxoplasmosis, congenital 284.9 D61.9 Aplastic anemia 854.00 S09.8XXS Traumatic Head Injury 299.00 F84.0 Autism 759.5 Q85.1 Tuberous Sclerosis 749.20 *Q37.9 Cleft lip and palate 749.00 *Q35.9 Cleft palate OTHER SYNDROMES 771.1 P35.1 Congenital CMV - Cytomegalovirus 759.89 Q44.7 Alagille Syndrome 759.4 Q89.4 Conjoined twin 759.89 Q93.5 Angelman Syndrome 277.0x E84.x Cystic fibrosis 755.55 Q87.0 Apert Syndrome 259.4 E34.3 Dwarfism 299.80 F84.5 Asperger Syndrome 757.39 Q81.9 Epidermolysis Bullosa 759.89 Q87.3 Beckwith-Wiedemann Syndrome 767.6 P14.0 Erb's palsy (Brachial Plexis injury) 284.01 D61.0 Blackfan-Diamond Syndrome 783.41 *R62.51 Failure to Thrive 757.33 Q82.3 Bloch-Sulzberger Syndrome 284.09 D61.09 Fanconi Anemia 758.3 Q92.8 Cat Eye Syndrome 307.59 F98.29 Feeding Disorder 759.89 Q89.8 CHARGE Syndrome 756.79 Q79.3 Gastroschisis 759.89 Q87.1 Cockayne Syndrome 754.0 Q67.4 Hemifacial Microsomia 279.11 D82.1 DiGeorge Syndrome 771.2 *P35.2 Herpes, congenital 756.83 Q79.6 Ehlers-Danlos Syndrome G91.xx Hydrocephalus 448.1 I78.1 Epidermal Nevus Syndrome 778.0 P83.2 Hydrops-Fetalis 581.9 N04.9 Epstein's Syndrome 243 E00.9 Hypothyroidism, congenital 760.71 P04.3 Fetal Alcohol Syndrome 774.7 P57.8 Kernicterus 756.0 Q87.0 Goldenhar Syndrome 984.9 *T56.OX1A Lead Poisoning (15 mg/dl venous lead level or greater) 756.16 Q76.1 Klippel-Feil Syndrome 330.8 G31.82 Leigh's Disease 755.8 Q74.8 Larsen Syndrome 573.9 K76.9 Liver disease and/or dysfunction 759.89 Q87.1 Noonan Syndrome 765.01 *P07.01 Very Low Birth Weight <500 grams 756.0 *Q75.9 Pierre Robin Syndrome 765.02 *P07.02 Very Low Birth Weight 500-749 grams 760.70 *Q86.1 Fetal Hydantoin Syndrome 765.03 *P07.03 Very Low Birth Weight 750-999 grams 299.90 F84.9 Rett Syndrome 765.04 *P07.14 Very Low Birth Weight 1000-1250 grams 759.89 Q87.2 Rubinstein-Taybi Syndrome 765.05 *P07.15 Very Low Birth Weight 1250-1499 grams 759.89 Q87.1 Russell-Silver Syndrome 756.9 Q78.5 Metaphyseal dysplasia 995.55 T74.4XXs Shaken Baby Syndrome 277.9 E88.9 Mitochondrial myopathy 759.89 E78.72 Smith-Lemli-Optiz Syndrome 437.5 I67.5 Moyamoya disease 253.0 E22.0 Sotos Syndrome 359.x G71.0 Muscular dystrophy/Duchenne's 759.89 Q87.8 Stickler Syndrome (includes progressive muscular atrophy) 756.0 Q75.4 Treacher Collins Syndrome 742.59 Q06.8 Myelodysplasia 759.89 Q87.2 VACTER Syndrome 359.21 G71.11 Myotonic dystrophy 270.2 E70.3 Waardenburg-Klein Syndrome 237.70 Q85.00 Neurofibromatosis 759.89 Q93.8 Williams Syndrome 478.30 J38.00 Paralysis, vocal cords 279.12 D82.0 Wiskott-Aldrich Syndrome 299.80 F84.8 Pervasive Developmental Disorder (PDD) ICD-9 and ICD-10 CODES SIGNIFICANT DEVELOPMENTAL DELAY Children with Significant Developmental Delay are eligible for early intervention services until their third birthday unless there is a change in functioning. When there has been significant progress and whenever eligibility is questioned a multidisciplinary evaluation/assessment to redetermine eligibility must occur. The ICD-9 codes below are used for children eligible for early intervention due to significant developmental delay. SPECIFIC DELAYS IN DEVELOPMENT 315.31 F80.1 Expressive language disorder (Expressive language delay) 315.9 F88 Other disorders of psychological development 315.32 F80.2 Mixed expressive receptive language disorder (Developmental disorder, Global developmental delay; (Receptive language delay, Expressive/receptive Developmental delay cognitive; Sensory Integration language disorder) Disorder) 315.39 F80.89 Other developmental disorders of speech and language 315.9 Deleted: Unspecified delay in development 315.4 F82 Specific development disorder of motor function 783.42 R62.0 Delayed Milestones (Clumsiness, Motor delay; Gross motor (Delayed developmental milestones; delayed speech development delay, Fine motor delay, milestones; delayed milestone, late walker, late talker ) Neuromuscular disorder) 315.4 Deleted: Developmental coordination disorder (F82) R63.3 Feeding Difficulties 315.5 Deleted: Mixed development disorder (See F82) (Developmental delay in feeding) 315.8 Deleted: Other specific delays in development(See F88) 783.9 Deleted: Other symtoms concerning nutrition, October 2015 ICD-9/ICD10 Codes Established Conditions List and Developmental Delay Rev Feb 2016 metabolism and development (See R63.3) October 2015 ICD-9/ICD10 Codes Established Conditions List and Developmental Delay Rev Feb 2016.