F80.4 — Speech and language development delay due to hearing loss
F80.4 is a billable, specific ICD-10-CM code for speech and language development delay due to hearing loss. It is valid for submission on a claim.
Risk adjustment
F80.4 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
F80.4 is named in 13 Medicare coverage policies — 11 listing it as supporting medical necessity, and 2 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52434Health and Behavior Assessment/Intervention – Medical Policy Articlenot covered
- A56865Billing and Coding: Psychiatric Inpatient Hospitalizationnot covered
- A52866Billing and Coding: Speech-Language Pathology
- A53052Billing and Coding: Home Health Speech-Language Pathology
How F80.4 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to F80.4.
- Delay, delayed›development›language›due to hearing loss
- Delay, delayed›development›speech›due to hearing loss
Related codes at this level
Codes that share F80. If F80.4 is not quite right, the correct code is usually one of these.
Questions about F80.4
- Is F80.4 a billable ICD-10-CM code?
- Yes. F80.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does F80.4 sit in the tabular list?
- Mental, Behavioral and Neurodevelopmental disorders (F01-F99), in the block Pervasive and specific developmental disorders (F80-F89).