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ICD-10 Guide
ICD-10 CodesChapter 5: Mental, Behavioral and Neurodevelopmental disordersF81

F81

Billable

Specific developmental disorders of scholastic skills

Chapter 5:Mental, Behavioral and Neurodevelopmental disorders

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

Code Description

ICD-10 F81 is a billable code used to indicate a diagnosis of specific developmental disorders of scholastic skills.

Key Diagnostic Point:

Specific developmental disorders of scholastic skills encompass a range of neurodevelopmental disorders that primarily affect a child's ability to acquire academic skills. These disorders include dyslexia, dyscalculia, and dysgraphia, which manifest as difficulties in reading, mathematics, and writing, respectively. Children with these disorders may exhibit average or above-average intelligence but struggle significantly in academic performance due to their specific learning disabilities. The etiology of these disorders is multifactorial, involving genetic, neurological, and environmental factors. Diagnosis typically involves comprehensive assessments, including standardized testing and evaluations by educational psychologists or specialists. Early identification and intervention are crucial for improving outcomes, as children may benefit from tailored educational strategies, accommodations, and therapeutic support. It is important to differentiate these disorders from other neurodevelopmental conditions, such as autism spectrum disorder and communication disorders, which may co-occur but have distinct diagnostic criteria and treatment approaches.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and severity of learning disabilities
  • Need for comprehensive documentation to support diagnosis
  • Differentiation from other neurodevelopmental disorders
  • Potential for co-morbid conditions that complicate coding

Audit Risk Factors

  • Inadequate documentation of specific learning disabilities
  • Failure to provide evidence of educational assessments
  • Misclassification of learning disabilities as general developmental delays
  • Lack of clarity in distinguishing between co-morbid conditions

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed developmental history, educational assessments, and observations of academic performance.

Common Clinical Scenarios

Assessment of a child referred for academic struggles, evaluation of learning disabilities in school-aged children.

Billing Considerations

Consideration of co-existing conditions such as ADHD or autism spectrum disorders.

Psychology

Documentation Requirements

Comprehensive psychological evaluations, standardized test results, and behavioral observations.

Common Clinical Scenarios

Conducting assessments for learning disabilities, providing recommendations for educational interventions.

Billing Considerations

Need for collaboration with educational institutions for accurate diagnosis and intervention planning.

Coding Guidelines

Inclusion Criteria

Use F81 When
  • According to ICD
  • 10 guidelines, F81 codes should be used when a specific learning disorder is diagnosed, and it is essential to document the specific type of disorder (e
  • , dyslexia)

Exclusion Criteria

Do NOT use F81 When
  • Exclusion criteria include general developmental delays and other neurodevelopmental disorders that do not specifically affect scholastic skills

Related CPT Codes

96111CPT Code

Developmental testing

Clinical Scenario

Used for comprehensive assessments of learning disabilities.

Documentation Requirements

Detailed reports of testing results and recommendations.

Specialty Considerations

Psychologists and educational specialists should collaborate for accurate coding.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of learning disabilities, improving the ability to track and manage these conditions. The granularity of the codes helps in understanding the prevalence and treatment outcomes of specific disorders.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of learning disabilities, improving the ability to track and manage these conditions. The granularity of the codes helps in understanding the prevalence and treatment outcomes of specific disorders.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    American Psychiatric Association - DSM-5
  • •
    National Center for Learning Disabilities

Coding & Billing References

  • •
    American Psychiatric Association - DSM-5
  • •
    National Center for Learning Disabilities

Frequently Asked Questions

What is the difference between F81 and F80 codes?

F81 codes specifically address learning disabilities related to academic skills, while F80 codes pertain to communication disorders that may affect language and speech development.

How can I ensure accurate coding for learning disabilities?

Accurate coding requires thorough documentation of assessments, clear identification of the specific learning disorder, and consideration of any co-occurring conditions.