What is ICD-10 code F73?

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 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. F73 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. F73 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. F73 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 F73?

F73 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 F73 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 F73?

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

F73: Profound intellectual disabilities — ICD-10

ICD-10-CM Code View

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Code lookupF73Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

F73

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

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.

Buddy Insight

Profound intellectual disability represents an IQ below 20 with severely limited communication, mobility, and self-care abilities.

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 146

Severe Intellectual Disabilities

RAF 0.0

Code Trumping

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Code Book Path

Official

F7Intellectual Disabilities (F70-F79)

F73Profound intellectual disabilities

Inclusion Terms

Official

IQ level below 20-25
Profound mental subnormality

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for F73 in this effective period.

Related Child Codes

Official

ICD-10-CM does not list child codes under F73 for this display context.

Includes

Official

ICD-10-CM does not list Includes notes for F73 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for F73 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for F73 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for F73 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for F73 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

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)

MEAT Support

HCC Buddy guidance

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)

Audit Caution

HCC Buddy guidance

Using F79 (unspecified) or F72 (severe) when the provider has documented profound intellectual disability

Failing to capture all comorbid conditions that are extremely common in this population

Not distinguishing between developmental intellectual disability and acquired cognitive impairment from brain injury

Omitting the diagnosis because the patient presents in a skilled nursing facility and it seems 'obvious'

Common Mistakes

HCC Buddy guidance

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

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 F73 an HCC code?

No. F73 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 146, Severe 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 F73 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for F73

For F73to 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 F73 during that encounter, not just copy-forwarded from a problem list.

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 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 F73 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 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

Code Hierarchy

└F73Profound intellectual disabilities

F73 ICD-10-CM Code: Profound intellectual disabilities

HCC Buddy Code Card

F73

Is F73 an HCC code?

HCC Category Mapping

MEAT Criteria for F73

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What This Code Means

Coding Tips

Clinical Significance

Documentation Requirements

Commonly Confused Codes

Code Hierarchy

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