F71 ICD-10-CM Code: Moderate intellectual disabilities
F71 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software
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FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Intellectual Disabilities (F70-F79)
F71
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceModerate 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
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.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
MappedHCC 147
Code-level coefficient reference
Code Book Path
Inclusion Terms
Official- IQ level 35-40 to 50-55
- Moderate mental subnormality
Excludes 2
Official- symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99)Inherited from F01-F99
Related Codes
No related codes are included in this display for F71. Check the Code Book for the complete code path.
Includes
Official- disorders of psychological developmentInherited from F01-F99
Excludes 1
Official- borderline intellectual functioning, IQ above 70 to 84 (R41.83)Inherited from F70-F79
Code First
Official- any associated physical or developmental disordersInherited from F70-F79
Use Additional
OfficialNo Use Additional Code instructions are included in this display for F71. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for F71. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is F71 an HCC code?
F71 has no mapping under the current CMS-HCC V28 community payment model. F71 has a separate mapping under the Part D RxHCC model (HCC 147 (Moderate Intellectual Disability/Developmental Disorder)); the applicable result needs member context.
- Code
- F71
- Description
- Moderate intellectual disabilities
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.
Work F71 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for F71
For F71, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.
- 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
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 has no mapping under the current CMS-HCC V28 community payment model. F71 has a separate mapping under the Part D RxHCC model (HCC 147 (Moderate Intellectual Disability/Developmental Disorder)); the applicable result needs member context. Do not assign V28 risk adjustment value from this page; verify the applicable model and payment year before using this code for risk adjustment.
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.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, 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