EarlySteps Eligibility Criteria
EarlySteps Eligibility CriteriaICD-9 to ICD-10 CrosswalkPurpose: To assist early interventionists in identifying ICD-10 diagnosis codes using the EarlySteps eligibilitycriteria. The ICD-10 codes will be required for documentation and for billing for Medicaid-paid services fordates of service beginning 10/1/2015. The list below will replace the eligibility criteria list found in Chapter 5of the Practice Manual. Diagnoses highlighted in blue are additional codes added to the criteria or added tomatch the “drop down” code list on the eligibility tab used by the SPOEs in EIDS. In addition, the nature ofICD-10 allows for increased specificity in the use of diagnosis coding, therefore the most specific applicablecode should always be used. The sequence of the criteria in the list generally follows the sequence in thePractice Manual with some additional categories added to assist in locating codes. If you have questions,please contact your regional coordinator. August, 2015 updates are in red.Criteria DescriptionICD 9I. Developmental DelayGeneral Category—Specific delays indevelopmentDevelopmental speech/language disorder315315.3ICD 10Criteria 15.5315.8F82F82F88Other developmental disorders of speech andlanguageDevelopmental disorder of speech and languagenot otherwise specifiedExpressive language disorderMixed receptive-expressive language disorderCentral auditory processing disorderSpeech and language development delay due tohearing lossSpecific Developmental Disorder: Motor FunctionSpecific Developmental Disorder: Motor FunctionOther disorders of psychological developmentAbnormal sensory-motor responseAffective or social disorder/conditionOral-motor skills dysfunction, includingfeeding difficultiesIII. Established Medical ConditionsGenetic DisordersA. Chromosomal AbnormalitySyndromes – General Category783.42R62.0Delayed milestone in childhood783.3R63.3Feeding difficultiesDown syndromeTrisomy 13Trisomy 18General Category Autosomal .3Down syndrome, unspecifiedTrisomy 13, unspecified (Patau’s syndrome)Trisomy 18, unspecifiedCri-du-chatVelo-cardio-facial syndrome (VCFS)Other micro-deletion syndromes:include Miller-Dieker and Smith-MagenissyndromesDiGeorge n of short arm of chromosome 5Velo-cardio-facial syndromeOther microdeletions279.11D82.1Di George's syndromeF80.9Expressive language delayMixed receptive and expressive languagedelaySpeech and language delay due to hearinglossDevelopmental Coordination DisorderMixed Developmental DisorderOther specified delays in development315.31315.32II. Use of Informed Clinical Opinion toDetermine Eligibility758EarlySteps Established Medical Conditions ICD-10 Crosswalk – August, 20151
Criteria DescriptionICD 9ICD 10Criteria DescriptionFragile XPrader-Willi759.83759.81Q99.2Q87.1Other conditions due to autosomalanomaliesOther conditions due to chromosomalanomalies758.5Q92.8Fragile x chromosomeCongenital malformation syndromespredominantly associated with short statureOther specified trisomies and partial trisomies ofautosomes758.8758.81Conditions due to sex chromosomeanomalies, not includingKlinefelter’s Syndrome (XXY)(758.7 Q98.4)orTurner’s syndrome (XO)(758.6 Q98.9)Q97.0Q97.1Q97.2Q97.8Q98.5Q98.7Q98.8Karyotype 47, xxxFemale with more than three x chromosomesMosaicism, lines with various numbers of xchromosomesOther specified sex chromosome abnormalities,female phenotypeKaryotype 47, xyyMale with sex chromosome mosaicismOther specified sex chromosome abnormalities,male phenotypeOther specified chromosome abnormalitiesChromosomal abnormality, unspecified758.9Q99.8Q99.9B. Pre-natal exposuresFetal alcohol syndrome760.71P04.3Fetal hydantoin syndrome/Other760.79Q86.0P04.8Narcotics exposure760.72P04.49Hallucinogenic agent exposure760.73P04.49Cocaine exposure760.75P04.41Anticonvulsant exposure760.77P04.1Other Noxious influences affecting fetus ornewborn via placenta or breast milk760.79P04.8Newborn (suspected to be) affected by othermaternal noxious substancesDrug Withdrawal Syndrome779.5P96.1Neonatal withdrawal symptoms of maternal use ofdrugs of addictionWithdrawal symptoms from therapeutic use ofdrugs of newbornConditions due to anomaly of unspecifiedchromosome (includes Williams Syndrome)P96.2C. Neurocutaneous SyndromesCongenital pigmentary anomalies of the skin757.33Q82.1Newborn (suspected to be )affected by maternaluse of alcoholFetal alcohol syndrome (dysmorphic)Newborn (suspected to be) affected by othermaternal noxious substancesNewborn (suspected to be) affected by maternaluse of other drugs of addictionNewborn (suspected to be) affected by maternaluse of drugs of addictionNewborn (suspected to be) affected by maternaluse of cocaineNewborn (suspected to be) affected by othmaternal medicationNeurofibromatosisOther NeurofibromatosisSturge-Weber syndromeTuberous sclerosisD. Inborn Error of MetabolismDisorders of amino-acid transport .8Q85.1Xeroderma pigmentosumMastocytosisNeurofibromatosis, unspecifiedOther neurofibromatosisOther phakomatoses, not elsewhere classifiedTuberous sclerosis270.0Phenylketonuria (PKU)Other Disturbances of aromatic 70.21Disorders of amino-acid transport, unspecifiedCystinuriaCystinosisOther disorders of amino-acid transportClassical phenylketonuriaTyrosinemiaQ82.2EarlySteps Established Medical Conditions ICD-10 Crosswalk – August, 20152
Criteria DescriptionICD 9metabolismICD 10Criteria DescriptionE70.29E70.30E70.5E70.8Disturbances of Sulpher-bearing amino acidmetabolism270.4E72.10Disorder of Urea cycle metabolism270.6Other disturbances of straight-chain aminoacid ther specified disorders of amino-acidmetabolism270.8E72.03E72.8Unspecified disorder of amino acidmetabolismGeneral Category Disorders of CarbohydrateMetabolismGlycogenosis270.9E72.9Other disorders of tyrosine metabolismAlbinism, unspecifiedDisorders of tryptophan metabolismOther disorders of aromatic amino-acidmetabolismMaple-syrup-urine diseaseMethylmalonic acidemiaOther disorders of branched-chain amino-acidmetabolismDisorder of branched-chain amino-acidmetabolism, unspecifiedDisorders of sulphur-bearing amino-acidmetabolismHomocystinuriaOther disorders of sulphur-bearing amino-acidmetabolismDisorder of urea cycle metabolism, unspecifiedArginosuccinic aciduriaCitrullinemiaOther disorders of urea cycle metabolismDisorders of lysine and hydroxylysine metabolismOther specified disorders of amino-acidmetabolismLowe’s syndromeOther specified disorders of amino-acidmetabolismDisorder of amino-acid metabolism, 0Glycogen storage disease, unspecifiedvon Gierke diseaseMcArdle diseaseOther glycogen storage diseaseGalactosemiaPure .29E76.3Fabry (or Anderson-Fabry) diseaseGaucher diseaseNiemann-Pick disease, unspecifiedDefects in post-translational modification oflysosomal enzymesDefects in glycoprotein degradationLipoid dermatoarthritisOther lipoprotein metabolism disordersOther specified metabolic disordersHurler's syndromeScheie's syndromeMucopolysaccharidosis, type II-Hunter’s syndromeMorquio mucopolysaccharidoses, unspecifiedSanfilippo mucopolysaccharidosesOther mucopolysaccharidosesMucopolysaccharidosis, unspecifiedE75.23E75.25E75.29Krabbe diseaseMetachromatic leukodystrophyOther sphingolipidosisMaple Sugar Urine eral Category Disorders of LipidMetabolismLipidosesFabry’s disease- Gaucher’s disease- Niemann Pick- sphingolipidoses271.1272.0272.7Other disorders of lipid metabolism272.8Mucopolysaccaridoses277.5E. General Category: Cerebraldegenerations of the central nervoussystem—usually manifested in childhoodLeukodystrophy330.330.0EarlySteps Established Medical Conditions ICD-10 Crosswalk – August, 20153
Criteria DescriptionICD 9ICD 10Criteria DescriptionCerebral lipidoses such as TaySach’s330.1Cerebral degeneration in generalized -Sachs diseaseOther gangliosidosisNeuronal ceroid lipofuscinosisOther specified disorders of brainDisorder of brain, unspecifiedF84.2G31.81G31.82G94Rett's syndromeAlpers diseaseLeigh's diseaseOther disorders of brain in diseases classifiedelsewhereP35.0P35.1P35.2P37.1Congenital rubella syndromeCongenital cytomegalovirus infectionCongenital herpesviral [herpes simplex] infectionCongenital toxoplasmosisP37.2P37.8Neonatal (disseminated) listeriosisOther specified congenital infectious and parasiticdiseases253.0759.E22.0Acromegaly and pituitary 99.8E78.71E78.72Q87.1Q87.2Cerebral Degenerations of childhood in otherdiseasesOther specified degenerations in childhoodUnspecified cerebral degenerations inchildhoodF.Prenatal InfectionsTORCH” infections, including:Congenital rubellaCongenital cytomegalovirus infection (CMV)Congenital herpes simplex330.8330.9771.0771.1771.2Congenital toxoplasmosisG. Other SyndromesCerebral gigantismGeneral Category: Other and unspecifiedcongenital anomaliesPrader-willi syndrome759.9Q89.8Q89.9Congenital malformation syndromespredominantly associated with short statureMarfan's syndrome, unspecifiedFragile X chromosomeOther specified chromosome abnormalitiesBarth syndromeSmith-Lemli-Opitz syndromeCornelia de LangeCongenital malformation syndromespredominantly involving limbsCongenital malformation syndromes involvingearly overgrowth—Beckwith WiedemannOther congenital malformation syndromes withother skeletal changesAlport syndromeOther specified congenital malformationsyndromes, not elsewhere classifiedOther specified congenital malformationsCongenital anomaly, unspecified369.00H54.0Blindness, both eyes369.18H54.10Blindness, one eye, low vision other eye,unspecified eyesModerate or severe impairment, both eyesLow vision both eyes not otherwise specified369.2369.20H54.2Low vision, both eyesBetter eye: severe vision impairment; lesser369.21-H54.10Blindness, one eye, low vision other eye,Marfan syndromeFragile x syndromeOther specified chromosome abnormalitiesQ87.3Q87.5Q87.81Q87.89General Category: Congenital anomaly,unspecifiedH. Sensory Impairment - VisionVision--Impairment can be congenital oracquired (369—general category—morespecific diagnosis obtained from physician)Profound impairment, both eyes (369.0-)Moderate or severe impairment, better eye,profound impairment lesser eyeBlindness one eye; low vision other eye369.01-EarlySteps Established Medical Conditions ICD-10 Crosswalk – August, 20154
Criteria DescriptionICD 9ICD 10Criteria Descriptioneye; impairment not further specifiedBetter eye: moderate vision impairment;lesser eye: moderate vision impairmentUnqualified vision loss, both eyesLegal blindness, as defined in USARetrolental fibroplasia or retinopathy ofprematurityROP Stage 4ROP State 5359.24369.25H54.2unspecified eyesLow vision, both eyes369.3369.4362.26H54.3H54.8H35.159Unqualified vision loss, both eyesLegal blindness, as defined in USARetinopathy of prematurity, stage 4, unspecifiedeye362.27H35.169Bilateral retrolental fibroplasiaCortical BlindnessI.Sensory Impairment - Hearing--Hearingimpairment (25dB loss or greater) unilateralor bilateral General CategoryConductive hearing loss, unspecified—includes:Conductive hearing loss external earConductive hearing loss tympanic membraneConductive hearing loss middle earConductive hearing loss inner earConductive hearing loss, unilateral362.21377.75389H35.179H47.619Retinopathy of prematurity, stage 5, unspecifiedeyeRetrolental fibroplasia, unspecified eyeCortical blindness, unspecified side of brain389.00H90.2Conductive hearing loss, unspecified (includes389.00-389.04 and ive hearing loss, unilateral, right ear withunrestricted hearing on contralateral sideConductive hearing loss, unilateral, left ear withunrestricted hearing on contralateral sideConductive hearing loss, bilateralConductive hearing loss, unspecifiedUnspecified sensorineural hearing lossSensorineural Hearing loss, bilateralH90.12Conductive hearing loss, bilateralConductive hearing loss of combined typesSensorineural hearing lossSensory Hearing loss, bilateralNeural Hearing loss, bilateralSensorineural Hearing loss, bilateralMixed conductive and sensorineural hearinglossHearing loss unspecifiedCentral hearing lossJ. Orthopedic and Neurological DisordersAnoxic brain damageAnterior horn cell diseaseWerdnig-Hoffmann 90.8389.9389.14H91.90H90.5Mixed conductive and sensorineural hearing loss,unspecifiedUnspecified hearing loss, unspecified earUnspecified sensorineural hearing loss348.1335.—335.0G93.1Anoxic brain damage, not elsewhere classifiedG12.0Spinal muscular atrophy unspecifiedKugelberg-welander diseaseOther spinal muscular c lateral sclerosisProgressive muscular atrophyProgressive bulbar palsyPseudobulbar .8Primary lateral sclerosisOther motor neuron diseasesOther anterior horn cell diseases335.24335.29335.8G12.29G12.29G12.8Anterior horn cell disease unspecifiedGeneral Category: other specified muscledistordersArthrogryposis335.9G12.9Infantile spinal muscular atrophy, type I [WerdnigHoffman]Spinal muscular atrophy, unspecifiedOther inherited spinal muscular atrophyOther spinal muscular atrophies and relatedsyndromesAmyotrophic lateral sclerosisAmyotrophic lateral sclerosisProgressive bulbar palsyOther spinal muscular atrophies and relatedsyndromesOther motor neuron diseaseOther motor neuron diseaseOther spinal muscular atrophies and relatedsyndromesSpinal muscular atrophy, unspecified728.3M62.3Immobility syndrome (paraplegic)H90.0H90.2H90.5H903EarlySteps Established Medical Conditions ICD-10 Crosswalk – August, 20155
Criteria DescriptionICD 9ICD 10Criteria Other specified disorders of muscleArthrogryposis multiplex, congenitaErb's paralysis due to birth injuryKlumpke's paralysis due to birth injuryOther brachial plexus birth injuriesInjury of brachial plexus, initial encounterCerebral tic diplegic cerebral palsySpastic hemiplegic cerebral palsySpastic quadriplegic cerebral palsyOther cerebral palsySpastic hemiplegic cerebral palsyOther cerebral palsyCerebral palsy, unspecifiedLobster-claw hand, unspecified .6Q04.8Encephalocele, halyOther reduction deformities of brainMalformations of aqueduct of SylviusAtresia of foramina of Magendie and LuschkaOther congenital hydrocephalusMegalencephalyCongenital cerebral cystsOther specified congenital malformations of brainDiastematomyeliaHydromyeliaAmyeliaHypoplasia and dysplasia of spinal cordOther congenital cauda equina malformationsOther specified congenital malformations of spinalcordFamilial dysautonomia [Riley-Day]Other specified congenital malformations ofnervous systemCongenital malformation of nervous system,unspecifiedArthrogryposis multiplex, congenitaInjury to the Brachial plexus—birth trauma754.89767.6Brachial plexus—post perinatal originCerebral cystsCerebral palsy (all types)- General CategoryCongenital diplegiaCongenital HemiplegiaCongenital QuadriplegiaCongenital MonoplegiaInfantile hemiplegiaOther specified infantile cerebral palsyInfantile cerebral palsy unspecifiedCleft handCongenital anomalies of the centralnervous system – General CategoryEncephaloceleMicrocephalyCongenital reduction deformities of 43.9755.58742.--Congenital hydrocephaly742.3Other specified congenital anomalies ofbrain742.4Other specified congenital anomalies ofspinal cord—general categoryDiastematomyeliaHydromyeliaOther specified congenital anomalies ofspinal .3Q06.8Other specified congenital anomalies ofnervous system742.8G90.1Q07.8Unspecified congenital anomaly of brainspinal cord and nervous systemOther congenital musculoskeletalanomalies - General Category742.9Q07.9Reduction of deformities of upper limb755.20Q71.899Q71.90Transverse deficiency of upper limbLongitudinal deficiency of upper limbLongitudinal deficiency combined involvinghumerusLongitudinal deficiency , radioulner,complete or partialLongitudinal deficiency radial, complete 0755.26Q71.40742.0742.1742.2755.Q71.20Other reduction defects of unspecified upper limbUnspecified reduction defect of unspecified upperlimbCongenital complete absence of unspecifiedupper limbCongenital absence of unspecified upper arm andforearm with hand present.Congenital absence of both forearm and hand,unspecified upper limb.Longitudinal reduction defect of snspecified ratiusEarlySteps Established Medical Conditions ICD-10 Crosswalk – August, 20156
Criteria DescriptionICD 9ICD 10Criteria DescriptionLongitudinal deficiency, radial, complete orpartialLongitudinal deficiency ulnar, carpals ormetacarpals, phalanges, fingerReduction of deformities of lower limbsLongitudinal deficiency of lower limb, notclassified elsewhereTransverse deficiency of lower lime755.27Q71.50Longitudinal reduction defect of unspecified ulna755.28755.29755.30755.32Q71.30Congenital absence of unspecified hand/fingerQ72.899Other reduction defects of unspecified lower limb755.31Q72.00Longitudinal deficiency combined involvingtibia and fibulaLongitudinal deficiency femoral,complete/incompleteLongitudinal deficiency tibiofibular completeor partialLongitudinal deficiency, tibia,complete/partialLongitudinal deficiency, fibular,complete/partialLongitudinal deficiency, tarsals ormetatarsals complete/partialLongitudinal deficiency, phalanges,complete/partialReduction deformities, unspecified limb755.33Q72.10755.34Q72.40Congenital complete absence of unspecifiedlower limbCongenital absence of unspecified thigh andlower leg with foot presentLongitudinal reduction defect of unspecified .30Q72.70Congenital absence of unspecified foot and toesSplit foot, unspecified lower nital absence of unspecified limb(s)Phocomelia, unspecified limb(s)Other reduction defects of unspecified limb(s)Lobster-claw hand, unspecified handCraniosynostosisHypertelorismCongenital malformation of skull and face bones,unspecifiedOther congenital malformations of spine, notassociated with scoliosisThanatophoric short statureAchondroplasiaOther osteochondrodysplasia with defects ofgrowth of tubular bones and spineEnchondromatosisCongenital absence of both lower leg and foot,unspecified lower limbLongitudinal reduction defect of unspecified tibia755.39755.4Congenital cleft handAnomalies of skull and face bonePremature closure of cranial sutures755.58756.0Absence of vertebra, Q77.4Q77.8Osteodystrophies, unspecifiedOsteogenesis imperfectaOther symbolic dystunction-generalcategoryDevelopmental apraxia of asia, unspecifiedOsteogenesis imperfecta784.69Encephalopathy Not Otherwise SpecifiedFracture of vertebral column with spinal cordinjury (806) General Category—includeadditional diagnosis from iaOther symbolic dysfunctionsEncephalopathy, unspecifiedUnspecified displaced fracture of first cervicalvertebra, initial encounter for closed fractureUnspecified nondisplaced fracture of first cervicalvertebra, initial encounter for closed fractureUnspecified displaced fracture of second cervicalvertebra, initial encounter for closed fractureUnspecified non
metabolism E70.29 E70.30 E70.5 E70.8 Other disorders of tyrosine metabolism Albinism, unspecified Disorders of tryptophan metabolism Other disorders of aromatic amino-acid metabolism Maple Sugar Urine Disease 270.3 E71.0 E71.120 . E71.19
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