Relates to EI Eligibility / Diagnosed Condition with a high probablity of developmental delay CONV. TYPE. Approx. YES. NO Approx.

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1 to Conversion Table Billing Code: Billable / ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purpose Eligibility Code: /ICD-10 associated with diagnosed conditions with a high probability of and related to EIP eligibility Conversion (Conv.) Type: : Require clinical interpretation in order to determine the most appropriate conversion code(s) for your specific coding situation. Direct: An exact conversion from to ICD-10 ICD-10 DESCRIPTION E70.21 Tyrosinemia E70.29 Other disorders of tyrosine metabolism E70.30 Albinism, unspecified Arom amin-acid metab NEC E70.5 Disorders of tryptophan metabolism E70.8 Other disorders of aromatic amino-acid metabolism F84.0 F84.5 F84.8 Autistic disorder Asperger's syndrome Other pervasive developmental disorders Infantile Autism active state Pervasive Developmental Disorder (PDD) Pervasive Developmental Disorder (PDD) Autistic disorder, residual state Other specified pervasive developmental disorders, residual state Other specified pervasive developmental disorders, residual state F84.9 Pervasive developmental disorder, unspecified Unspecified pervasive developmental disorder, current or active state F50.8 Other eating disorders Psychogenic vomiting Other disorders of eating F98.29 Other feeding disorders of infancy and early childhood Other disorders of eating F43.10 Post-traumatic stress disorder, unspecified F43.12 Post-traumatic stress disorder, chronic Prolonged Post Traumatic Stress Disorder F93.9 Childhood emotional disorder, unspecified Emotional dis child S F94.8 Other childhood disorders of social functioning Emotional dis child S Adj react-emotion NEC F98.9 Unspecified behavioral and emotional disorders with onset usually occurring in childhood and adolescence Emotional dis child S Overanxious disorder F93.8 Other childhood emotional disorders Relationship problems Identity disorder Emotional dis child NEC F94.1 Reactive attachment disorder of childhood Emotional dis child NEC F98.8 Reactive attachment disorder of childhood Emotional dis child NEC F90.0 Attention-deficit hyperactivity disorder, predominantly inattentive type No Prolonged Attention Deficit Disorder w/o Hyperactivity F90.9 Attention-deficit hyperactivity disorder, unspecified type Prolonged Attention Deficit Disorder w/o Hyperactivity Attention Deficit/Hyperactivity Disorder-combined type Hyperkinetic synd S F90.1 Attention-deficit hyperactivity disorder, predominantly hyperactive type Attention Deficit/Hyperactivity Disorder-combined type F90.2 Attention-deficit hyperactivity disorder, combined type Attention Deficit/Hyperactivity Disorder-combined type F80.1 Expressive language disorder Direct Expressive language dis F80.2 Mixed receptive-expressive language disorder Recp-expres language dis H93.25 Central auditory processing disorder Recp-expres language dis F80.4 Speech and language development delay due to hearing loss Direct Speech del d/t hear loss F80.0 Phonological disorder Speech/language dis NEC F80.89 Other developmental disorders of speech and language Speech/language dis NEC F82 Specific developmental disorder of motor function Developmental coordination disorder (Apraxia F88 Other disorders of psychological development Other specified delays in development F81.9 Developmental disorder of scholastic skills, unspecified Development delay S V40.0 Mental and behavioral problems with learning F89 Unspecified disorder of psychological development Development delay S G12.0 Infantile spinal muscular atrophy, type I [Werdnig-Hoffman] Direct Werdnig-Hoffmann disease G80.9 Cerebral palsy, unspecified Direct Cerebral palsy S G80.1 Spastic diplegic cerebral palsy Direct Congenital diplegia G80.2 Spastic hemiplegic cerebral palsy Congenital hemiplegia Infantile hemiplegia ICD-10 --> 1 of 5

2 DESCRIPTION G80.0 Spastic quadriplegic cerebral palsy Direct Congenital, quadriplegia G80.8 Other cerebral palsy Congenital monoplegia Other specified infantile cerebral palsy G Epileptic spasms, not intractable, with status epilepticus G Epileptic spasms, not intractable, without status epilepticus Infantile Spasms, without Intractable Epilepsy G Epileptic spasms, intractable, with status epilepticus Infantile spasms, with intractable epilepsy G Epileptic spasms, intractable, without status epilepticus Infantile spasms, with intractable epilepsy G71.2 Congenital myopathies Cong hered musc dystrphy G72.89 Other specified myopathies Myopathies NEC G72.9 Myopathy, unspecified Myopathy, unspecified H Retrolental fibroplasia, unspecified eye Retrolental fibroplasia H Retinopathy of prematurity, stage 4, unspecified eye Retinoph prematr.stage 4 H Retinopathy of prematurity, stage 4, right eye Retinoph prematr.stage 4 H Retinopathy of prematurity, stage 4, left eye Retinoph prematr.stage 4 H Retinopathy of prematurity, stage 4, bilateral Retinoph prematr.stage 4 H Retinopathy of prematurity, stage 5, unspecified eye Retinoph prematr,stage 5 H Retinopathy of prematurity, stage 5, left eye Retinoph prematr,stage 5 H Retinopathy of prematurity, stage 5, right eye Retinoph prematr,stage 5 H Retinopathy of prematurity, stage 5, bilateral Retinoph prematr,stage 5 H35.50 Unspecified hereditary retinal dystrophy Direct Hered retin dystrphy S Blindness, both eyes H54.0 Blindness, both eyes Better eye: total vision impairment; lesser eye: total vision impairment H54.1 Blindness, one eye, low vision other eye H54.10 Blindness, one eye, low vision other eye, unspecified eyes Blindness, one eye, low vision other eye Low vision both eyes (moderate to severe) H54.2 Low vision, both eyes Better eye: moderate vision impairment; lesser eye: moderate vision impairment H54.3 Unqualified visual loss, both eyes Direct Unqualified visual loss, both eyes H54.4 Blindness, one eye H54.5 Low vision, one eye H54.6 Unqualified visual loss, one eye H54.7 Unspecified visual loss Unspecified visual loss v41.0 Problems with sight H54.8 Legal blindness, as defined in USA Legal blindness, as defined in U.S.A H Coloboma of optic disc, unspecified eye H Coloboma of optic disc, right eye H Coloboma of optic disc, left eye Optic nerve coloboma (bilateral), acquired H Coloboma of optic disc, bilateral H55.03 Visual deprivation nystagmus Direct Visual deprivation nystagmus H55.01 Congenital nystagmus Direct Congenital nystagmus H90.2 Conductive hearing loss, unspecified Conductive Hearing Loss - S Conduc hear loss ext ear H90.11 H90.12 Conductive hearing loss, unilateral, right ear, with unrestricted hearing on the Conductive hearing loss, unilateral, left ear, with unrestricted hearing on the H90.0 Conductive hearing loss, bilateral Conduct hear loss tympan Conduc hear loss mid ear Cond hear loss inner ear Condctv hear loss,unilat Cond hear loss comb type Conduc hear loss ext ear Conduct hear loss tympan Conduc hear loss mid ear Cond hear loss inner ear Condctv hear loss,unilat Cond hear loss comb type Conduc hear loss ext ear Conduct hear loss tympan Conduc hear loss mid ear Cond hear loss inner ear Condctv hear loss, bilat Cond hear loss comb type Sensorineural Hearing Loss (Nos.) ICD-10 --> 2 of 5

3 DESCRIPTION H90.5 Unspecified sensorineural hearing loss Central hearing loss Sensoneur hear loss asym Sensry hearng loss,bilat H90.3 Sensorineural hearing loss, bilateral Neural hearng loss,bilat Central hearing loss Sensonrl hear loss,bilat Neural hear loss, unilat H90.41 Sensorineural hearing loss, unilateral, right ear, with unrestricted hearing on Central hearing loss the Sensorneur hear loss uni Sensory hear loss,unilat Neural hear loss, unilat H90.42 Sensorineural hearing loss, unilateral, left ear, with unrestricted hearing on the Central hearing loss Sensorneur hear loss uni Sensory hear loss,unilat H90.8 Mixed conductive and sensorineural hearing loss, unspecified Direct Mixed Conductive and Sensorineural Hearing Loss H90.71 Mixed conductive and sensorineural hearing loss, unilateral, right ear, with unrestricted hearing on the Mixed hearing loss,unilt H90.72 Mixed conductive and sensorineural hearing loss, unilateral, left ear, with unrestricted hearing on the Mixed hearing loss,unilt H90.6 Mixed conductive and sensorineural hearing loss, bilateral Direct Mixed hearing loss,bilat I Other speech and language deficits following unspecified cerebrovascular Late ef-spch/lng def S disease Late ef-spch/lang df NEC M43.6 Torticollis Direct Torticollis S Q05.4 Unspecified spina bifida with hydrocephalus Spina Bifida with hydrocephalus (unspecified region) Q07.01 Arnold-Chiari syndrome with spina bifida Spina Bifida with hydrocephalus (unspecified region) Q07.02 Arnold-Chiari syndrome with hydrocephalus Spina Bifida with hydrocephalus (unspecified region) Q07.03 Arnold-Chiari syndrome with spina bifida and hydrocephalus Spina Bifida with hydrocephalus (unspecified region) M62.81 Muscle weakness (generalized) Direct Muscle weakness-general M62.9 Disorder of muscle, unspecified Muscle/ligament dis S Q05.0 Cervical spina bifida with hydrocephalus Direct Spin bif w hydrceph-cerv Q05.1 Thoracic spina bifida with hydrocephalus Direct Spin bif w hydrceph-dors Q05.2 Lumbar spina bifida with hydrocephalus Spin bif w hydrceph-lumb Q05.8 Sacral spina bifida without hydrocephalus Spina Bifida w/o hydrocephalus (unspecified region) Q05.5 Cervical spina bifida without hydrocephalus Direct Spina bifida-cerv Q05.6 Thoracic spina bifida without hydrocephalus Direct Spina bifida-dorsal Q05.7 Lumbar spina bifida without hydrocephalus Direct Spina bifida-lumbar Q01.9 Encephalocele, unspecified Q01.0 Frontal encephalocele Q01.1 Nasofrontal encephalocele Encephalocele Q01.2 Occipital encephalocele Q01.8 Encephalocele of other sites Q05.3 Sacral spina bifida with hydrocephalus Spin bif w hydrceph-lumb Q05.8 Spina bifida without mention of hydrocephalus, unspecified region Spina Bifida w/o hydrocephalus (unspecified region) Q02 Microcephaly Direct Microcephalus Q04.1 Arhinencephaly Q04.2 Holoprosencephaly Q04.3 Other reduction deformities of brain Reduction deform, brain Q04.0 agenesis of corpus callosum Q03.0 Malformations of aqueduct of Sylvius Q03.1 Atresia of foramina of Magendie and Luschka Q03.8 Other congenital hydrocephalus Congenital hydrocephalus Q03.9 Congenital hydrocephalus, unspecified Q04.5 Megalencephaly Q04.6 Congenital cerebral cysts Brain anomaly NEC Q04.8 Other specified congenital malformations of brain Q13.1 Absence of iris Direct Aniridia Q14.2 Congenital malformation of optic disc Optic nerve coloboma (bilateral), congenital Q16.9 Congenital malformation of ear causing impairment of hearing, unspecified Unspecified anomalies of the ear with hearing impairment Ear anom NEC/impair hear Q16.0 Congenital absence of (ear) auricle Cong absence ext ear Q16.1 Congenital absence, atresia and stricture of auditory canal (external) Ex ear anm NEC-impr hear ICD-10 --> 3 of 5

4 DESCRIPTION Q16.4 Other congenital malformations of middle ear Direct Middle ear anomaly NEC Q16.3 Congenital malformation of ear ossicles Direct Anomalies ear ossicles Q16.5 Congenital malformation of inner ear Direct Anomalies of inner ear Q35.9 Cleft palate, unspecified Q35.3 Cleft soft palate Cleft Palate Q35.5 Cleft hard palate with cleft soft palate Q35.7 Cleft uvula Unilat cleft palate-inc Q36.0 Cleft lip, bilateral Bilat cleft lip-complete Bilat cleft lip-incompl Q36.1 Cleft lip, median Unilat cleft lip-compl Cleft lip, unspecified Q36.9 Cleft lip, unilateral Unilat cleft lip-compl Unilat cleft lip-imcompl Q37.0 Q37.1 Q37.2 Q37.3 Q37.4 Q37.5 Q37.8 Cleft hard palate with bilateral cleft lip Cleft hard palate with unilateral cleft lip Cleft soft palate with bilateral cleft lip Cleft soft palate with unilateral cleft lip Cleft hard and soft palate with bilateral cleft lip Cleft hard and soft palate with unilateral cleft lip Unspecified cleft palate with bilateral cleft lip Q37.9 Unspecified cleft palate with unilateral cleft lip Cleft palate with cleft lip, unspecified Q68.0 Congenital deformity of sternocleidomastoid muscle Direct Congenital torticollis Q Other reduction defects of unspecified upper limb Reduc deform up limb S Q Other reduction defects of unspecified lower limb Reduction deform leg S Q73.0 Congenital absence of unspecified limb(s) Q73.1 Phocomelia, unspecified limb(s) Reduct deform limb S Q73.8 Other reduction defects of unspecified limb(s) Q74.8 Other specified congenital malformations of limb(s) Direct Congen limb anomaly NEC Q71.63 Lobster-claw hand, bilateral Q71.61 Lobster-claw right hand Lobster Claw (Hand) Q71.62 Lobster-claw left hand Q90.9 Down syndrome, unspecified Q90.0 Trisomy 21, nonmosaicism (meiotic nondisjunction) Q90.1 Trisomy 21, mosaicism (mitotic nondisjunction) Down syndrome Q90.2 Trisomy 21, translocation Q91.7 Trisomy 13, unspecified Q91.4 Trisomy 13, nonmosaicism (meiotic nondisjunction) Q91.5 Trisomy 13, mosaicism (mitotic nondisjunction) Pataus syndrome Q91.6 Trisomy 13, translocation Q91.3 Trisomy 18, unspecified Q91.0 Trisomy 18, nonmosaicism (meiotic nondisjunction) Q91.1 Trisomy 18, mosaicism (mitotic nondisjunction) Edwards syndrome Q91.2 Trisomy 18, translocation Q91.3 Trisomy 18, unspecified Q89.7 Multiple congenital malformations, not elsewhere classified Direct Angelman's Syndrome (syndromes affecting multiple systems) Q87.1 Congenital malformation syndromes predominantly associated with short stature Prader-Willi Syndrome Q99.2 Fragile X chromosome Direct Fragile X Syndrome E78.71 Barth syndrome E78.72 Smith-Lemli-Opitz syndrome Q87.2 Congenital malformation syndromes predominantly involving limbs Q87.3 Congenital malformation syndromes involving early overgrowth Q87.5 Other congenital malformation syndromes with other skeletal changes CHARGE Association ICD-10 --> 4 of 5

5 Q87.81 Alport syndrome Q87.89 Other specified congenital malformation syndromes, not elsewhere classified DESCRIPTION Q89.8 Other specified congenital malformations Q86.0 Fetal alcohol syndrome (dysmorphic) P04.3 Newborn (suspected to be) affected by maternal use of alcohol Fetal Alcohol Syndrome P07.01 P07.02 P07.03 P07.00 Extremely low birth weight newborn, less than 500 grams Extremely low birth weight newborn, grams Extremely low birth weight newborn, grams Extremely low birth weight newborn, unspecified weight Extreme Prematurity Less than 500 grams Extreme Prematurity grams Extreme Prematurity grams Extreme immatur wts Preterm NEC <500g Preterm NEC g Preterm NEC g Preterm infant NEC wts P52.22 Intraventricular (nontraumatic) hemorrhage, grade 4, of newborn Direct NB intraven hem,grade iv P91.2 Neonatal cerebral leukomalacia Preventricular leukomalacia P57.8 Other specified kernicterus P57.9 Kernicterus, unspecified NB kernicterus R27.0 Ataxia, unspecified R27.8 Other lack of coordination Lack of coordination R27.9 Unspecified lack of coordination R Other symptoms and signs involving the nervous system Nerve/musculskel sym NEC R Nerve/musculskel sym NEC Other symptoms and signs involving the musculoskeletal system Muscskel sympt limb NEC R29.90 Unspecified symptoms and signs involving the nervous system R29.91 Unspecified symptoms and signs involving the musculoskeletal system Nerve/musculskel sym NEC R62.50 Unspecified lack of expected normal physiological development in childhood Lack norm physio dev S R62.51 Failure to thrive (child) Direct Failure to thrive-child R62.0 Delayed milestone in childhood Direct Delayed milestones R47.02 Dysphasia Speech disturbance NEC R47.81 Slurred speech Speech disturbance NEC R47.89 Other speech disturbances Speech disturbance NEC V41.4 Voice production problem R48.1 Agnosia R48.2 Apraxia Symbolic dysfunction NEC R48.8 Other symbolic dysfunctions Ill-define condition NEC R69 Illness, unspecified Unkn cause morb/mort NEC V41.9 Probl w special func S R99 Ill-defined and unknown cause of mortality Unkn cause morb/mort NEC Sudden infant death synd S14.109A Unspecified injury at unspecified level of cervical spinal cord, initial encounter S24.109A Unspecified injury at unspecified level of thoracic spinal cord, initial encounter Spinal cord injury S S34.109A Unspecified injury to unspecified level of lumbar spinal cord, initial encounter S34.139A Unspecified injury to sacral spinal cord, initial encounter ICD-10 --> 5 of 5

CONV. TYPE Unspecified pervasive developmental disorder YES NO Approx. F84.9 Pervasive developmental disorder, unspecified YES YES 307.

CONV. TYPE Unspecified pervasive developmental disorder YES NO Approx. F84.9 Pervasive developmental disorder, unspecified YES YES 307. to Conversion Table Billing Code: Billable ICD-9/ -CM code that can be used to indicate a diagnosis for reimbursement purpose Eligibility Code: ICD-9/ associated with diagnosed conditions with a high probability