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ICD-10 Guide
ICD-10 CodesF81.9

F81.9

Billable

Developmental disorder of scholastic skills, unspecified

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

Code Description

ICD-10 F81.9 is a billable code used to indicate a diagnosis of developmental disorder of scholastic skills, unspecified.

Key Diagnostic Point:

F81.9 refers to a developmental disorder characterized by difficulties in academic skills that are not attributable to other medical or psychological conditions. This disorder encompasses a range of learning disabilities that can affect reading, writing, and mathematics. Individuals with this condition may struggle with tasks such as reading comprehension, spelling, and numerical operations, which can significantly impact their educational performance and self-esteem. The unspecified nature of this code indicates that the specific type of learning disability has not been clearly defined or diagnosed. It is essential to consider the broader context of neurodevelopmental disorders, including autism spectrum disorders and communication disorders, as these can co-occur with learning disabilities and complicate the clinical picture. Accurate diagnosis often requires comprehensive assessments, including standardized testing and evaluations by educational professionals, psychologists, and other specialists. Early identification and intervention are crucial for improving outcomes and supporting the individual's educational journey.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation of learning disabilities
  • Overlap with other neurodevelopmental disorders
  • Need for comprehensive documentation
  • Potential for co-occurring conditions

Audit Risk Factors

  • Insufficient documentation of learning difficulties
  • Lack of standardized assessment results
  • Failure to document co-occurring conditions
  • Inconsistent use of the code across different providers

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed developmental history, assessment results, and educational impact.

Common Clinical Scenarios

Evaluating a child with poor academic performance and suspected learning disabilities.

Billing Considerations

Consideration of developmental milestones and potential referrals to specialists.

Psychology

Documentation Requirements

Comprehensive psychological evaluations, including cognitive and academic testing.

Common Clinical Scenarios

Conducting assessments for children with suspected learning disorders.

Billing Considerations

Documentation must clearly outline the assessment process and findings.

Coding Guidelines

Inclusion Criteria

Use F81.9 When
  • According to ICD
  • 10 guidelines, F81
  • 9 should be used when there is a clear indication of a developmental disorder affecting scholastic skills but without a specific diagnosis
  • Coders should ensure that documentation supports the use of this code and that it is not used when a more specific code is applicable

Exclusion Criteria

Do NOT use F81.9 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

96130CPT Code

Psychological testing evaluation services

Clinical Scenario

Used when conducting assessments for learning disabilities.

Documentation Requirements

Detailed report of testing results and recommendations.

Specialty Considerations

Psychologists must ensure comprehensive evaluations are documented.

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, but F81.9 remains a useful code for cases where the specific type of learning disorder is not yet determined. It emphasizes the need for thorough documentation to support the diagnosis.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of learning disabilities, but F81.9 remains a useful code for cases where the specific type of learning disorder is not yet determined. It emphasizes the need for thorough documentation to support the diagnosis.

Reimbursement & Billing Impact

impact on the patient's educational performance. Providers should ensure that all relevant information is included to justify the use of this code.

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 F81.9 and other specific learning disorder codes?

F81.9 is used when the specific type of learning disorder has not been identified, while other codes specify particular deficits in reading, writing, or mathematics.