Impairment categories guide

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Impairment categories guide

Guidance in this document is not approved for use unless you view it in PACE.

This article provides guidance for an access delegate to:

• understand what impairment categories to select for a person that meets the eligibility

requirements.

Recent updates

14 October 2024

New guidance to:

• reflect legislation changes from 3 October 2024 • decide what impairment categories to select for a person that meets the eligibility

requirements.

Impairments categories guide

Impairments are a loss of or damage to a body’s function. When we assess an impairment to meet access, we look at:

• the body’s function • the body’s structure • how they think and learn.

To learn more about impairment categories go to article Descriptions of impairment categories.

The following list provides you with information on:

• the condition • the ICD 10 Code • the required impairment category for access assessors to select • optional impairment categories to select as relevant, based on evidence provided with

access request.

Conditions

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Autism (ASD)

  1. Autism – includes Rett and Asperger Syndrome

ICD 10 Codes: F84.0, F84.2, F84.5

Required impairment category: Neurological

Optional impairment categories: Intellectual, cognitive, physical, psychosocial

Acquired brain injury

  1. Glioblastoma

ICD 10 Code: G71.9

Required impairment category: Neurological

Optional impairment categories: Cognitive, physical, psychosocial

  1. Hypoxic brain injury

ICD 10 Code: 93.1

Required impairment category: Neurological

Optional impairment categories: Physical, psychosocial

  1. Traumatic brain injury – also called head injury and acquired brain damage

ICD 10 Code: T90

Required impairment category: Neurological

Optional impairment categories: Cognitive, physical, psychosocial

Intellectual disability

  1. Mild intellectual disability

ICD 10 Codes: F70

Required impairment category: Intellectual

Optional impairment categories: Cognitive

  1. Moderate intellectual disability

ICD 10 Codes: F71

Required impairment category: Intellectual

Optional impairment categories: Cognitive, physical, psychosocial

  1. Severe intellectual disability

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ICD 10 Codes: F72

Required impairment category: Intellectual

Optional impairment categories: Cognitive, physical, psychosocial

  1. Profound intellectual disability

ICD 10 Codes: F73

Required impairment category: Intellectual

Optional impairment categories: Cognitive, physical, psychosocial

  1. Unspecified intellectual disability

ICD 10 Codes: F79

Required impairment category: Intellectual

Optional impairment categories: Cognitive, sensory, physical, psychosocial

  1. Pervasive developmental disorder

ICD 10 Codes: F84.8

Required impairment category: Intellectual

Optional impairment categories: Cognitive, sensory, psychosocial

  1. Microcephaly

ICD 10 Codes: Q02

Required impairment category: Intellectual

Optional impairment categories: Cognitive, neurological, sensory, physical

  1. Other congenital brain conditions – for example, tuberous sclerosis

ICD 10 Codes: Q04

Required impairment category: Intellectual

Optional impairment categories: Cognitive, neurological, physical

  1. Spina bifida

ICD 10 Codes: Q05

Required impairment category: Physical

Optional impairment categories: Intellectual, cognitive, sensory, neurological

  1. Foetal alcohol syndrome

ICD 10 Codes: Q86.0

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Required impairment category: Neurological

Optional impairment categories: Intellectual, cognitive, sensory, physical, psychosocial

  1. Foetal alcohol spectrum disorder (FASD)

ICD 10 Codes: Q86.0D

Required impairment category: Neurological

Optional impairment categories: Intellectual, cognitive, sensory, physical, psychosocial

  1. Cornelia de Lange syndrome

ICD 10 Codes: Q87.1

Required impairment category: Intellectual

Optional impairment categories: Cognitive, neurological, sensory, physical, psychosocial

  1. Prader Willi syndrome

ICD 10 Codes: Q87.1

Required impairment category: Intellectual

Optional impairment categories: Cognitive, neurological, physical, psychosocial

  1. Coffin-Lowry syndrome

ICD 10 Codes: Q87.8

Required impairment category: Intellectual

Optional impairment categories: Cognitive, neurological, sensory, physical, psychosocial

  1. Other congenital conditions (causing intellectual disability)

ICD 10 Codes: Q89

Required impairment category: Intellectual

Optional impairment categories: Cognitive, neurological, sensory, physical, psychosocial

  1. Edwards syndrome

ICD 10 Codes: Q91

Required impairment category: Intellectual

Optional impairment categories: Cognitive, neurological, sensory, physical, psychosocial

  1. Patau syndrome

ICD 10 Codes: Q91

Required impairment category: Intellectual

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Optional impairment categories: Cognitive, neurological, sensory, physical, psychosocial

  1. Cri du Chat syndrome

ICD 10 Codes: Q93.4

Required impairment category: Intellectual

Optional impairment categories: Cognitive, sensory, physical

  1. Angelman syndrome

ICD 10 Codes: Q93.5

Required impairment category: Intellectual

Optional impairment categories: Cognitive, sensory, physical

  1. Other chromosomal syndromes (including Kabuki & Williams syndromes)

ICD 10 Codes: Q99

Required impairment category: Intellectual

Optional impairment categories: Cognitive, neurological, sensory, physical, psychosocial

  1. Fragile X syndrome

ICD 10 Codes: Q99.2

Required impairment category: Intellectual

Optional impairment categories: Cognitive, neurological, sensory, physical, psychosocial

Cerebral Palsy

  1. Cerebral palsy

ICD 10 Codes: G80

Required impairment category: Physical

Optional impairment categories: Intellectual, cognitive, neurological, sensory

Down Syndrome

  1. Down syndrome

ICD 10 Codes: Q90

Required impairment category: Intellectual

Optional impairment categories: Cognitive, physical

Hearing Impairment

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  1. Hearing loss

ICD 10 Codes: H90

Required impairment category: Sensory

Optional impairment categories: Cognitive

  1. Congenital hearing condition

ICD 10 Codes: Q16.9

Required impairment category: Sensory

Optional impairment categories: Cognitive

Visual Impairment

  1. Albinism

ICD 10 Codes: E70.3

Required impairment category: Sensory

Optional impairment categories: Not applicable

  1. Visual impairment (including blindness)

ICD 10 Codes: H54

Required impairment category: Sensory

Optional impairment categories: Not applicable

  1. Congenital eye conditions

ICD 10 Codes: Q15.9

Required impairment category: Sensory

Optional impairment categories: Not applicable

Other Sensory - Speech

  1. Other sensory - speech

ICD 10 Codes: R47

Required impairment category: Sensory

Optional impairment categories: Physical

Multiple Sclerosis

  1. Multiple Sclerosis

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ICD 10 Codes: G35

Required impairment category: Neurological

Optional impairment categories: Cognitive, physical, psychosocial

Other Neurological

  1. Alzheimer’s disease

ICD 10 Codes: F00

Required impairment category: Cognitive

Optional impairment categories: Neurological, physical, psychosocial

  1. Unspecified dementia

ICD 10 Codes: F03

Required impairment category: Cognitive

Optional impairment categories: Neurological, physical, psychosocial

  1. Huntington disease

ICD 10 Codes: G10

Required impairment category: Physical

Optional impairment categories: Cognitive, neurological, psychosocial

  1. Motor neurone disease

ICD 10 Codes: G12.2

Required impairment category: Physical

Optional impairment categories: Cognitive, neurological, sensory, psychosocial

  1. Parkinson’s disease

ICD 10 Codes: G20

Required impairment category: Neurological

Optional impairment categories: Cognitive, physical, psychosocial

  1. Epilepsy – Mandatory TAPIB

ICD 10 Codes: G40

Required impairment category: Neurological

Optional impairment categories: Intellectual, cognitive, psychosocial

  1. Muscular dystrophy

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ICD 10 Codes: G71.0

Required impairment category: Physical

Optional impairment categories: Neurological

  1. Other Neurological – List A and List C

ICD 10 Codes: G99

Required impairment category: Neurological

Optional impairment categories: Cognitive, sensory, physical

Stroke

  1. Stroke

ICD 10 Codes: I69

Required impairment category: Physical

Optional impairment categories: Cognitive, neurological, sensory, psychosocial

Other Physical

  1. Rheumatoid arthritis

ICD 10 Codes: M05

Required impairment category: Physical

Optional impairment categories: Not applicable

  1. Other arthritis – mandatory TAPIB

ICD 10 Codes: M12

Required impairment category: Physical

Optional impairment categories: Not applicable

  1. Other physical

ICD 10 Codes: M95

Required impairment category: Physical

Optional impairment categories: Psychosocial

  1. Multiple traumatic amputations

ICD 10 Codes: T05

Required impairment category: Physical

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Optional impairment categories: Psychosocial

  1. Myopathy

ICD 10 Codes: G72.9

Required impairment category: Physical

Optional impairment categories: Not applicable

Psychosocial disability

  1. Schizophrenia

ICD 10 Codes: F20

Required impairment category: Psychosocial

Optional impairment categories: Cognitive

  1. Schizoaffective disorder

ICD 10 Codes: F25.9

Required impairment category: Psychosocial

Optional impairment categories: Cognitive

  1. Bipolar affective disorder

ICD 10 Codes: F31

Required impairment category: Psychosocial

Optional impairment categories: Cognitive

  1. Major depressive illness

ICD 10 Codes: F32

Required impairment category: Psychosocial

Optional impairment categories: Cognitive

  1. Other anxiety disorders

ICD 10 Codes: F41

Required impairment category: Psychosocial

Optional impairment categories: Cognitive

  1. Obsessive-compulsive disorder

ICD 10 Codes: F42

Required impairment category: Psychosocial

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Optional impairment categories: Not applicable

  1. Post traumatic stress disorder

ICD 10 Codes: F43

Required impairment category: Psychosocial

Optional impairment categories: Cognitive

  1. Borderline personality disorder

ICD 10 Codes: F60.3

Required impairment category: Psychosocial

Optional impairment categories: Not applicable

  1. Tourette syndrome

ICD 10 Codes: F95.2

Required impairment category: Neurological

Optional impairment categories: Cognitive, physical, psychosocial

  1. Other psychosocial disorders

ICD 10 Codes: F99

Required impairment category: Psychosocial

Optional impairment categories: Cognitive

  1. Anorexia

ICD 10 Codes: R63

Required impairment category: Psychosocial

Optional impairment categories: Cognitive, physical

Spinal Cord Injury

  1. Malignant neoplasm of spinal cord complete and incomplete

ICD 10 Codes: C72.5, C72.7

Required impairment category: Physical

Optional impairment categories: Neurological, sensory

  1. Spinal cord injury (complete)

ICD 10 Codes: T09.5

Required impairment category: Physical

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Optional impairment categories: Neurological, sensory, psychosocial

  1. Spinal cord injury (incomplete)

ICD 10 Codes: T09.7

Required impairment category: Physical

Optional impairment categories: Neurological, sensory, psychosocial

Other

  1. Malignant neoplasm of brain

ICD 10 Codes: C71

Required impairment category: Neurological

Optional impairment categories: Cognitive, psychosocial

  1. Metastatic cancer

ICD 10 Codes: C79.9

Required impairment category: Physical

Optional impairment categories: Cognitive

  1. Malignant neoplasm of blood or immune disease

ICD 10 Codes: C96

Required impairment category: Physical

Optional impairment categories: Cognitive

  1. Autoimmune disorders

ICD 10 Codes: D89.9

Required impairment category: Physical

Optional impairment categories: Cognitive

  1. Obesity – mandatory TAPIB

ICD 10 Codes: E66

Required impairment category: Physical

Optional impairment categories: Psychosocial

  1. Classical phenylketonuria

ICD 10 Codes: E70.0

Required impairment category: Cognitive

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Optional impairment categories: Psychosocial

  1. Disorders of pyruvate metabolism and gluconeogenesis

ICD 10 Codes: E74.4

Required impairment category: Intellectual

Optional impairment categories: Neurological, physical

  1. Other metabolic disorders

ICD 10 Codes: E88

Required impairment category: Intellectual

Optional impairment categories: Neurological, physical

  1. Dementia – rapidly progressing

ICD 10 Codes: F03.9

Required impairment category: Cognitive

Optional impairment categories: Not applicable

  1. Functional neurological disorder (FND) – mandatory TAPIB

ICD 10 Codes: F44.4

Required impairment category: Neurological

Optional impairment categories: Cognitive, sensory, physical

  1. Other language disorder

ICD 10 Codes: F80

Required impairment category: Cognitive

Optional impairment categories: Not applicable

  1. Peripheral neuropathy – does NOT require TAPIB

ICD 10 Codes: F90.0

Required impairment category: Neurological

Optional impairment categories: Sensory, physical

  1. Oppositional defiant disorder (ODD)

ICD 10 Codes: F91.3

Required impairment category: Cognitive

Optional impairment categories: Psychosocial

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  1. Other hereditary ataxias

ICD 10 Codes: G11.8

Required impairment category: Neurological

Optional impairment categories: Cognitive, sensory, physical

  1. Dementia – early onset

ICD 10 Codes: G30.0

Required impairment category: Cognitive

Optional impairment categories: Not applicable

  1. Plegia

ICD 10 Codes: G83.1

Required impairment category: Physical

Optional impairment categories: Neurological

  1. Chronic pain – mandatory TAPIB

ICD 10 Codes: G89.4

Required impairment category: Physical

Optional impairment categories: Sensory, psychosocial

  1. Postural Orthostatic Tachycardia Syndrome (POTS) – mandatory TAPIB

ICD 10 Codes: I49.8

Required impairment category: Neurological

Optional impairment categories: Physical

  1. Lymphoedema – mandatory TAPIB

ICD 10 Codes: I89.0

Required impairment category: Physical

Optional impairment categories: Not applicable

  1. Chronic lung disease

ICD 10 Codes: J44.9

Required impairment category: Physical

Optional impairment categories:

  1. Chronic Obstructive Pulmonary Disease (COPD) – mandatory TAPIB

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ICD 10 Codes: J44.9A

Required impairment category: Physical

Optional impairment categories: Not applicable

  1. Osteoarthritis – mandatory TAPIB

ICD 10 Codes: M19.9

Required impairment category: Physical

Optional impairment categories: Not applicable

  1. Systemic lupus erythematosus

ICD 10 Codes: M32

Required impairment category: Physical

Optional impairment categories: Not applicable

  1. Ankylosing spondylitis

ICD 10 Codes: M45

Required impairment category: Physical

Optional impairment categories: Not applicable

  1. Fibromyalgia

ICD 10 Codes: M79.7

Required impairment category: Physical

Optional impairment categories: Sensory

  1. Renal failure

ICD 10 Codes: N18

Required impairment category: Physical

Optional impairment categories:

  1. Ehlers Danlos – does NOT require TAPIB

ICD 10 Codes: Q79.6

Required impairment category: Physical

Optional impairment categories: Not applicable

  1. Dyslexia

ICD 10 Codes: R48

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Required impairment category: Cognitive

Optional impairment categories: Psychosocial

  1. Childhood apraxia of speech

ICD 10 Codes: R48.2

Required impairment category: Neurological

Optional impairment categories: Cognitive

  1. Short stature

ICD 10 Codes: R62.5

Required impairment category: Physical

Optional impairment categories: Not applicable

  1. Amputation – single limb or upper/lower limb

ICD 10 Codes: Z89

Required impairment category: Physical

Optional impairment categories: Cognitive, sensory, psychosocial

  1. Amputation – multiple

ICD 10 Codes: Z89.1

Required impairment category: Physical

Optional impairment categories: Cognitive, sensory, psychosocial

Article labels

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Version control

Version Amended Brief Description of Change Status

by

0.1 VFK746 |Draft transfer of endorsed Attachment A DRAFT 2024-10-03

— Descriptions of impairment categories

to KA — required for legislation updates 0.2 TCM150 |Peer review DRAFT 2024-10-03 0.3 VFK746_ |Implementation of Peer Review DRAFT 2024-10-03 0.4 JMO122 |EL1 review and approval DRAFT 2024-10-07 0.5 VFK746 |Class 1 endorsement — progress to BM DRAFT 2024-10-08 1.0 JCO0088 |Class 3 approval to QA and publish APPROVED | 2024-10-10

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