ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 F78.A1

Billable / Specific

SYNGAP1-related intellectual disability

F78
Block
0
Synonyms
103
LCDs
5
Payer Policies
0
Linked CPTs

About ICD-10-CM F78.A1

ICD-10-CM code F78.A1 represents SYNGAP1-related intellectual disability. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F78). The 2026 edition of ICD-10-CM F78.A1 became effective on October 1, 2025.

Coding Notes

Code Also

  • , if applicable, any associated:
  • autism spectrum disorder (F84.0)
  • autistic disorder (F84.0)
  • encephalopathy (G93.4-)
  • epilepsy and recurrent seizures (G40.-)
  • other pervasive developmental disorders (F84.8)
  • pervasive developmental disorder, NOS (F84.9)

Medicare LCD Coverage for F78.A1

Local Coverage Determinations (LCDs) from CMS MACs that list F78.A1 as a covered diagnosis.

103 LCDs

Showing top 10 of 103 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Psychiatric Inpatient Hospitalization
Article ID: 57052, Effective: 2026-03-26 00:00:00, 422 covered, 0 non-covered
CPT XX000 →
CMS LCD: Billing and Coding: Psychiatric Partial Hospitalization Programs
Article ID: 57053, Effective: 2026-03-26 00:00:00, 400 covered, 0 non-covered
CPT 90899 →
CMS LCD: Billing and Coding: Psychiatric Partial Hospitalization Programs
Article ID: 57053, Effective: 2026-03-26 00:00:00, 400 covered, 0 non-covered
CPT 96131 →
CMS LCD: Billing and Coding: Psychiatric Partial Hospitalization Programs
Article ID: 57053, Effective: 2026-03-26 00:00:00, 400 covered, 0 non-covered
CPT 96146 →
CMS LCD: Billing and Coding: Psychiatric Partial Hospitalization Programs
Article ID: 57053, Effective: 2026-03-26 00:00:00, 400 covered, 0 non-covered
CPT 96136 →
CMS LCD: Billing and Coding: Psychiatric Partial Hospitalization Programs
Article ID: 57053, Effective: 2026-03-26 00:00:00, 400 covered, 0 non-covered
CPT G0176 →
CMS LCD: Billing and Coding: Psychiatric Partial Hospitalization Programs
Article ID: 57053, Effective: 2026-03-26 00:00:00, 400 covered, 0 non-covered
CPT 90837 →
CMS LCD: Billing and Coding: Psychiatric Partial Hospitalization Programs
Article ID: 57053, Effective: 2026-03-26 00:00:00, 400 covered, 0 non-covered
CPT 96116 →
CMS LCD: Billing and Coding: Psychiatric Partial Hospitalization Programs
Article ID: 57053, Effective: 2026-03-26 00:00:00, 400 covered, 0 non-covered
CPT 90785 →
CMS LCD: Billing and Coding: Psychiatric Partial Hospitalization Programs
Article ID: 57053, Effective: 2026-03-26 00:00:00, 400 covered, 0 non-covered
CPT 90847 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing F78.A1.

5 policies

5 Medicare

Billing and Coding: Psychiatric Inpatient Hospitalization
Policy ID: ART-57052
Billing and Coding: Psychiatric Partial Hospitalization Programs
Policy ID: ART-57053
Billing and Coding: Psychiatric Codes
Policy ID: ART-57130
Billing and Coding: MRI and CT Scans of the Head and Neck
Policy ID: ART-57204
Billing and Coding: Psychological and Neuropsychological Tests
Policy ID: ART-57780

CPT Codes Commonly Billed with F78.A1

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for F78.A1

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

ICD-10 F78.A1, Billing FAQ

Is ICD-10 code F78.A1 billable? +

Yes, F78.A1 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Get the full PayerReady toolkit

Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.

Start free →

Run this code through our claim audit tool

Check NCCI bundling, MUE limits, and modifier logic before submission.

Try the auditor →

Did this page help?

Quick signal so we know what to improve.

Thanks!

If you want a code reference page that doesn't exist yet, email coding@payerready.com.

Sorry to hear that.

Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.

Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on June 1, 2026.

Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team

Faster Approvals

Ready to Cut Your Enrollment Timeline in Half?

Join providers in all 50 states who handed off credentialing to a dedicated specialist. Create your free account in minutes and start enrolling the same day.

All 50 States Covered
No Long-Term Contracts
HIPAA HIPAA Compliant Platform
Dedicated Specialist Included