F73 ICD-10-CM Code: Profound intellectual disabilities
F73 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools
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FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Intellectual Disabilities (F70-F79)
F73
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceProfound intellectual disabilities
A developmental condition where a person has profound intellectual disability, the most severe level, meaning they have very limited intellectual functioning and require continuous, intensive support for all daily activities.
Buddy Insight
Profound intellectual disability represents an IQ below 20 with severely limited communication, mobility, and self-care abilities.
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 146
Code-level coefficient reference
Code Book Path
Inclusion Terms
Official- IQ level below 20-25
- Profound 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 F73. 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 F73. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for F73. 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 F73 an HCC code?
F73 has no mapping under the current CMS-HCC V28 community payment model. F73 has a separate mapping under the Part D RxHCC model (HCC 146 (Profound or Severe Intellectual Disability/Developmental Disorder)); the applicable result needs member context.
- Code
- F73
- Description
- Profound 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 F73 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for F73
For F73, 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
F73 is the ICD-10-CM diagnosis code for profound intellectual disabilities. A developmental condition where a person has profound intellectual disability, the most severe level, meaning they have very limited intellectual functioning and require continuous, intensive support for all daily activities. F73 sits in the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99), within the section covering intellectual disabilities (f70-f79).
F73 has no mapping under the current CMS-HCC V28 community payment model. F73 has a separate mapping under the Part D RxHCC model (HCC 146 (Profound or Severe 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.
Ensure documentation clearly establishes profound level with IQ testing and comprehensive adaptive functioning assessment.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for F73 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Ensure documentation clearly establishes profound level with IQ testing and comprehensive adaptive functioning assessment
- •Document the need for 24/7 supervision and support for all activities of daily living
Clinical Significance
Profound intellectual disability represents an IQ below 20 with severely limited communication, mobility, and self-care abilities. These individuals require 24-hour support and are fully dependent on caregivers for all activities of daily living. They have the highest rates of comorbid medical conditions among intellectual disability groups, including epilepsy, sensory impairments, and physical disabilities. Healthcare requires specialized adaptive approaches.
Documentation Requirements
- ✓Provider documentation of intellectual disability with specification of severity as profound
- ✓Formal cognitive testing (IQ below 20) or clinical assessment supporting profound severity
- ✓Documentation of complete dependence on caregivers for all activities of daily living
- ✓Assessment of communication abilities (often nonverbal or preverbal)
- ✓Documentation of 24-hour care requirements, guardianship, and specialized support systems
Commonly Confused Codes
- •F72: Severe intellectual disabilities; severe ID (IQ 20-34) retains some rudimentary self-care capacity unlike profound
- •F79: Unspecified intellectual disabilities; profound severity must be specified when documented
- •G93.1: Anoxic brain damage; acquired brain damage may cause profound cognitive deficits but is coded separately from developmental intellectual disability
- •R41.0: Disorientation, unspecified; cognitive impairment codes are not substitutes for intellectual disability diagnosis