What is ICD-10 code F71?

F71 is the ICD-10-CM diagnosis code for Moderate intellectual disabilities. It belongs to the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99). F71 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. F71 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. F71 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. F71 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for F71?

F71 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither model rewards F71 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a payment HCC.

What should coders know when reporting F71?

F71 is used for individuals with moderate intellectual disability; ensure documentation specifies the severity level to distinguish from mild (F70) or severe (F72) intellectual disabilities This code should be accompanied by documentation of adaptive functioning deficits and typically requires supporting assessments or psychological evaluations in the medical record

F71: Moderate intellectual disabilities — ICD-10

ICD-10-CM Code View

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Code lookupF71Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Intellectual Disabilities (F70-F79)

F71

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Moderate intellectual disabilities

Moderate intellectual disability refers to a significant limitation in intellectual functioning and adaptive behaviors that develops during childhood, resulting in a person needing substantial support in daily living skills, communication, and self-care. Individuals with this condition typically have an IQ between 35-49 and require ongoing assistance with education, employment, and independent living.

Buddy Insight

CMS-HCC V28

Not risk-adjusted for this model/period.

RAF 0

CMS-HCC V24

Not risk-adjusted for this model/period.

RAF 0

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Not risk-adjusted for this model/period.

RAF 0

RXHCC

Mapped

HCC 147

Moderate Intellectual Disabil...

RAF 0.0

Code Trumping

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Code Book Path

Official

F7Intellectual Disabilities (F70-F79)

F71Moderate intellectual disabilities

Inclusion Terms

Official

IQ level 35-40 to 50-55
Moderate mental subnormality

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for F71 in this effective period.

Related Child Codes

Official

ICD-10-CM does not list child codes under F71 for this display context.

Includes

Official

ICD-10-CM does not list Includes notes for F71 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for F71 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for F71 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for F71 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for F71 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Provider documentation of intellectual disability with specification of severity as moderate

Formal cognitive testing (IQ approximately 35-49) or clinical assessment supporting moderate severity

Documentation of adaptive functioning deficits requiring moderate support in conceptual, social, and practical domains

Assessment of communication abilities and capacity for healthcare decision-making

MEAT Support

HCC Buddy guidance

Provider documentation of intellectual disability with specification of severity as moderate

Formal cognitive testing (IQ approximately 35-49) or clinical assessment supporting moderate severity

Documentation of adaptive functioning deficits requiring moderate support in conceptual, social, and practical domains

Assessment of communication abilities and capacity for healthcare decision-making

Audit Caution

HCC Buddy guidance

Using F79 (unspecified) when the provider clearly documents moderate severity

Not coding moderate intellectual disability as an active ongoing condition — it is lifelong and should be reported at each encounter where it impacts care

Failing to code comorbid conditions (epilepsy, behavioral disorders) that frequently accompany moderate ID

Coding based on educational classification rather than clinical diagnostic criteria

Common Mistakes

HCC Buddy guidance

F70 — Mild intellectual disabilities; mild ID has higher functional capacity (IQ 50-69) with less intensive support needs

F72 — Severe intellectual disabilities; severe ID (IQ 20-34) requires extensive support beyond what moderate ID needs

F79 — Unspecified intellectual disabilities; use F71 when moderate severity is documented

F78.A1 — SYNGAP1-related intellectual disability; genetic-specific codes take precedence when the etiology is identified

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is F71 an HCC code?

No. F71 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

HCC Category Mapping

RxHCCHCC 147, Moderate Intellectual Disabilities

0.000

RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

Work F71 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for F71

For F71to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
EEvaluate: test results, medication response, or physical findings reviewed by the provider
AAssess: explicit mention in the assessment or plan with acknowledgment of status
TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed F71 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

F71 is the ICD-10-CM diagnosis code for moderate intellectual disabilities. Moderate intellectual disability refers to a significant limitation in intellectual functioning and adaptive behaviors that develops during childhood, resulting in a person needing substantial support in daily living skills, communication, and self-care. Individuals with this condition typically have an IQ between 35-49 and require ongoing assistance with education, employment, and independent living. F71 sits in the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99), within the section covering intellectual disabilities (f70-f79).

F71 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

This code does not map to a CMS-HCC V28 payment category. Capture depends on documentation that supports the diagnosis; verify the HCC assignment against the current CMS mapping for the applicable payment year. Coders reviewing F71 should check whether additional documentation would support a more specific child code in the same hierarchy that does map to a payment HCC, capturing the correct specificity is the highest-impact RAF improvement available within accurate coding.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for F71 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•F71 is used for individuals with moderate intellectual disability; ensure documentation specifies the severity level to distinguish from mild (F70) or severe (F72) intellectual disabilities
•This code should be accompanied by documentation of adaptive functioning deficits and typically requires supporting assessments or psychological evaluations in the medical record

Clinical Significance

Moderate intellectual disability represents an IQ range of approximately 35-49 and is characterized by slow language development, limited academic achievement, and the ability to learn basic self-care with moderate supervision. These individuals require consistent support in daily living and healthcare management. Comorbid conditions including epilepsy, behavioral disorders, and physical disabilities are common and add to care complexity.

Documentation Requirements

✓Provider documentation of intellectual disability with specification of severity as moderate
✓Formal cognitive testing (IQ approximately 35-49) or clinical assessment supporting moderate severity
✓Documentation of adaptive functioning deficits requiring moderate support in conceptual, social, and practical domains
✓Assessment of communication abilities and capacity for healthcare decision-making
✓Documentation of comorbid conditions, current living arrangement, and support services in place

Commonly Confused Codes

•F70: Mild intellectual disabilities; mild ID has higher functional capacity (IQ 50-69) with less intensive support needs
•F72: Severe intellectual disabilities; severe ID (IQ 20-34) requires extensive support beyond what moderate ID needs
•F79: Unspecified intellectual disabilities; use F71 when moderate severity is documented
•F78.A1: SYNGAP1-related intellectual disability; genetic-specific codes take precedence when the etiology is identified

Code Hierarchy

└F71Moderate intellectual disabilities

F71 ICD-10-CM Code: Moderate intellectual disabilities

HCC Buddy Code Card

F71

Is F71 an HCC code?

HCC Category Mapping

MEAT Criteria for F71

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What This Code Means

Coding Tips

Clinical Significance

Documentation Requirements

Commonly Confused Codes

Code Hierarchy

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