ICD-10 Coding for Borderline Intellectual Functioning(R41.83)
Complete ICD-10-CM coding and documentation guide for Borderline Intellectual Functioning. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Borderline Intellectual Functioning
R40-R46Primary Range
Symptoms and signs involving cognition, perception, emotional state and behavior
This range includes codes for cognitive and perceptual symptoms, including borderline intellectual functioning.
Intellectual disabilities
This range is relevant for differentiating intellectual disabilities from borderline intellectual functioning.
Key Information: ICD-10 code for borderline intellectual functioning
Essential facts and insights about Borderline Intellectual Functioning
Primary ICD-10-CM Code for borderline intellectual functioning
Decision Criteria
clinical Criteria
- IQ between 71-84 with functional limitations
coding Criteria
- Do not use as a principal diagnosis when another condition is present
Applicable To
- IQ 71-84
- Functional limitations in adaptive domains
Excludes
- Intellectual disabilities (F70-F79)
Clinical Validation Requirements
- IQ test results showing scores between 71 and 84
- Documentation of adaptive functioning deficits
Code-Specific Risks
- Confusion with intellectual disability codes
- Incorrect use as a principal diagnosis
Coding Notes
- Ensure IQ and adaptive functioning are documented to support R41.83.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Educational and occupational problems
Z55.8Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Borderline Intellectual Functioning to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R41.83.
Impact
Clinical: May lead to misdiagnosis., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Use specific IQ scores and adaptive functioning details.
Impact
Reimbursement: Incorrect coding may lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Query provider to confirm IQ and adaptive functioning details.
Impact
Lack of specific documentation can lead to audit issues.
Mitigation Strategy
Ensure comprehensive documentation of IQ tests and adaptive deficits.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Borderline Intellectual Functioning, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Borderline Intellectual Functioning
Use these documentation templates to ensure complete and accurate documentation for Borderline Intellectual Functioning. These templates include all required elements for proper coding and billing.
Primary Care Assessment
Specialty: Primary CareRequired Elements
- IQ test name and score
- Adaptive deficits
- Functional impact
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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