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ICD-10 Guide
ICD-10 CodesF06.7

F06.7

Billable

Mild neurocognitive disorder due to known physiological condition

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 F06.7 is a billable code used to indicate a diagnosis of mild neurocognitive disorder due to known physiological condition.

Key Diagnostic Point:

Mild neurocognitive disorder due to known physiological condition is characterized by a decline in cognitive function that is not severe enough to interfere significantly with daily living activities. This condition is secondary to a known physiological cause, such as traumatic brain injury, neurodegenerative diseases, or metabolic disorders. Patients may exhibit symptoms such as memory impairment, difficulty with attention and concentration, and changes in executive function. Unlike more severe forms of neurocognitive disorders, individuals with mild neurocognitive disorder can often maintain independence in daily activities, although they may require assistance with complex tasks. The diagnosis requires a comprehensive assessment, including a detailed medical history, neurological examination, and cognitive testing to differentiate it from other cognitive disorders. It is essential to identify the underlying physiological condition contributing to the cognitive decline, as this can guide treatment and management strategies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating from other neurocognitive disorders
  • Need for comprehensive documentation of underlying physiological conditions
  • Variability in symptoms and severity among patients
  • Potential overlap with other mental health diagnoses

Audit Risk Factors

  • Inadequate documentation of the physiological condition
  • Failure to provide cognitive assessment results
  • Misdiagnosis or overlap with other mental health conditions
  • Lack of clear treatment plans or follow-up documentation

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological examination findings, cognitive assessment results, and history of the physiological condition.

Common Clinical Scenarios

Patients with mild cognitive impairment following a stroke or traumatic brain injury.

Billing Considerations

Ensure that the underlying physiological condition is clearly documented to support the diagnosis.

Psychiatry

Documentation Requirements

Comprehensive mental status examination and history of psychiatric and medical conditions.

Common Clinical Scenarios

Patients with cognitive decline associated with chronic medical conditions such as diabetes or hypertension.

Billing Considerations

Differentiating between neurocognitive disorder and other psychiatric conditions is crucial.

Coding Guidelines

Inclusion Criteria

Use F06.7 When
  • According to ICD
  • 10 guidelines, F06
  • 7 should be used when there is clear evidence of cognitive decline due to a known physiological condition
  • Documentation must include the specific physiological condition and cognitive assessment results

Exclusion Criteria

Do NOT use F06.7 When
  • Exclusion criteria include primary neurocognitive disorders without a known physiological cause

Related ICD-10 Codes

Related CPT Codes

96116CPT Code

Neuropsychological testing

Clinical Scenario

Used to assess cognitive function in patients suspected of having mild neurocognitive disorder.

Documentation Requirements

Results of cognitive assessments and interpretation by a qualified professional.

Specialty Considerations

Documentation must clearly link the cognitive assessment to the diagnosis of F06.7.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more precise coding of neurocognitive disorders, enabling better tracking of conditions like F06.7. This specificity aids in research and treatment planning, improving patient outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more precise coding of neurocognitive disorders, enabling better tracking of conditions like F06.7. This specificity aids in research and treatment planning, improving patient outcomes.

Reimbursement & Billing Impact

impact on daily functioning. Clear linkage between diagnosis and treatment is essential for reimbursement.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the difference between mild neurocognitive disorder and major neurocognitive disorder?

Mild neurocognitive disorder involves cognitive decline that does not significantly impair daily functioning, while major neurocognitive disorder results in substantial impairment in daily activities and requires assistance.