F78.A1
F78.A1: SYNGAP1-related intellectual disability
Billable / specific codeICD-10-CM
F78.A1 is a billable, specific ICD-10-CM code for syngap1-related intellectual disability. It is valid for submission on a claim.
Check F78.A1 with the rest of the claim: free scrubberCode also
Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
F78.A1 is named in 7 Medicare coverage policies: 5 listing it as supporting medical necessity, and 2 listing it as NOT covered. Which one applies depends on your Medicare contractor.
- A52434Health and Behavior Assessment/Intervention – Medical Policy Articlenot covered
- A56865Billing and Coding: Psychiatric Inpatient Hospitalizationnot covered
- A57052Billing and Coding: Psychiatric Inpatient Hospitalization
- A57053Billing and Coding: Psychiatric Partial Hospitalization Programs
Alphabetic index entries that lead here
- Disability, disabilities›intellectual›SYNGAP1-related
- Disability, disabilities›intellectual›genetic related›SYNGAP1-related
- Disability, disabilities›intellectual›with›pathogenic SYNGAP1(genetic) (variant)
- Disability, disabilities›intellectual›genetic related›with›pathogenic SYNGAP1(variant)
Code history
Unchanged in every release from FY2024 to FY2027.