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ICD-10 Guide
ICD-10 CodesR41.83

R41.83

Borderline intellectual functioning

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 R41.83 is a billable code used to indicate a diagnosis of borderline intellectual functioning.

Key Diagnostic Point:

Borderline intellectual functioning is characterized by cognitive abilities that are below average but not low enough to meet the criteria for intellectual disability. Individuals with this condition typically have an IQ score ranging from 70 to 84. Symptoms may include difficulties in learning, problem-solving, and adapting to everyday life situations. These individuals may struggle with academic performance, social interactions, and independent living skills. Clinical assessments often reveal challenges in reasoning, planning, and abstract thinking. While borderline intellectual functioning is not classified as a mental disorder, it can significantly impact an individual's quality of life and may co-occur with other psychological or developmental disorders. Early identification and intervention are crucial for improving outcomes, and a multidisciplinary approach involving psychologists, educators, and healthcare providers is often necessary for effective management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in IQ testing and interpretation
  • Overlap with other cognitive disorders
  • Need for comprehensive documentation of symptoms
  • Potential for co-occurring conditions

Audit Risk Factors

  • Inadequate documentation of cognitive assessments
  • Misclassification with intellectual disabilities
  • Failure to document co-occurring conditions
  • Lack of clear functional impairment evidence

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed history of cognitive functioning, assessment results, and any co-morbid conditions.

Common Clinical Scenarios

Patients presenting with learning difficulties, social challenges, or academic underachievement.

Billing Considerations

Consider the impact of chronic medical conditions on cognitive functioning.

Emergency Medicine

Documentation Requirements

Acute assessment of cognitive status, including any immediate safety concerns.

Common Clinical Scenarios

Patients presenting with confusion or altered mental status.

Billing Considerations

Rapid assessment of cognitive function is critical; ensure clarity in documentation to avoid misdiagnosis.

Coding Guidelines

Inclusion Criteria

Use R41.83 When
  • Follow official ICD
  • CM guidelines for coding symptoms and signs
  • Ensure that the diagnosis is supported by clinical documentation and that the patient's functional limitations are clearly outlined

Exclusion Criteria

Do NOT use R41.83 When
No specific exclusions found.

Related CPT Codes

96101CPT Code

Psychological testing

Clinical Scenario

Used for comprehensive cognitive assessments in patients suspected of having borderline intellectual functioning.

Documentation Requirements

Detailed report of testing results and interpretation.

Specialty Considerations

Psychologists should ensure that the testing aligns with the diagnosis and document findings thoroughly.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of cognitive and intellectual conditions, improving the ability to capture the nuances of borderline intellectual functioning compared to ICD-9.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of cognitive and intellectual conditions, improving the ability to capture the nuances of borderline intellectual functioning compared to ICD-9.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of cognitive and intellectual conditions, improving the ability to capture the nuances of borderline intellectual functioning compared to ICD-9.

Resources

Clinical References

  • •
    American Psychiatric Association - Diagnostic and Statistical Manual of Mental Disorders

Coding & Billing References

  • •
    American Psychiatric Association - Diagnostic and Statistical Manual of Mental Disorders

Frequently Asked Questions

What is the difference between borderline intellectual functioning and intellectual disability?

Borderline intellectual functioning refers to cognitive abilities that are below average but do not meet the criteria for intellectual disability, which requires more significant impairments in adaptive functioning.