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Impairment categories guide SGP KP Publishing

        Exported on 2025-04-02 22:33:43

SGP KP Publishing – Impairment categories guide

Table of Contents

1 Recent updates …………………………………………………………………………………………………….. 4 2 Impairments categories guide ……………………………………………………………………………….. 5 3 Conditions …………………………………………………………………………………………………………….. 6 3.1 Autism (ASD) ………………………………………………………………………………………………………. 6 3.2 Acquired brain injury ……………………………………………………………………………………. 6 3.3 Intellectual disability ……………………………………………………………………………………………… 6 3.4 Cerebral Palsy ………………………………………………………………………………………………….. 8 3.5 Down Syndrome ………………………………………………………………………………………………….. 8 3.6 Hearing Impairment ……………………………………………………………………………………………… 8 3.7 Visual Impairment ………………………………………………………………………………………………… 8 3.8 Other Sensory - Speech ……………………………………………………………………………………. 8 3.9 Multiple Sclerosis …………………………………………………………………………………………………. 8 3.10 Other Neurological ……………………………………………………………………………………………. 9 3.11 Stroke ……………………………………………………………………………………………………………… 9 3.12 Other Physical ………………………………………………………………………………………………….. 9 3.13 Psychosocial disability …………………………………………………………………………………….. 10 3.14 Spinal Cord Injury …………………………………………………………………………………………… 10 3.15 Other …………………………………………………………………………………………………………….. 11

                                                                       Table of Contents – 2

SGP KP Publishing – Impairment categories guide

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 – 3

SGP KP Publishing – Impairment categories guide

1 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.

                                                                     Recent updates – 4

SGP KP Publishing – Impairment categories guide

2 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.

                                                             Impairments categories guide – 5

SGP KP Publishing – Impairment categories guide

3 Conditions

3.1 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

3.2 Acquired brain injury

1. Glioblastoma
  ICD 10 Code: G71.9
   Required impairment category: Neurological
   Optional impairment categories: Cognitive, physical, psychosocial
2. Hypoxic brain injury
  ICD 10 Code: 93.1
   Required impairment category: Neurological
   Optional impairment categories: Physical, psychosocial
3. 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

3.3 Intellectual disability

1. Mild intellectual disability
  ICD 10 Codes: F70
   Required impairment category: Intellectual
   Optional impairment categories: Cognitive
2. Moderate intellectual disability
  ICD 10 Codes: F71
   Required impairment category: Intellectual
   Optional impairment categories: Cognitive, physical, psychosocial
3. Severe intellectual disability
  ICD 10 Codes: F72
   Required impairment category: Intellectual
   Optional impairment categories: Cognitive, physical, psychosocial
4. Profound intellectual disability
  ICD 10 Codes: F73
   Required impairment category: Intellectual
   Optional impairment categories: Cognitive, physical, psychosocial
5. Unspecified intellectual disability
  ICD 10 Codes: F79
   Required impairment category: Intellectual
   Optional impairment categories: Cognitive, sensory, physical, psychosocial
6. Pervasive developmental disorder
  ICD 10 Codes: F84.8
   Required impairment category: Intellectual
   Optional impairment categories: Cognitive, sensory, psychosocial
7. Microcephaly
  ICD 10 Codes: Q02
   Required impairment category: Intellectual
   Optional impairment categories: Cognitive, neurological, sensory, physical
8. Other congenital brain conditions – for example, tuberous sclerosis
  ICD 10 Codes: Q04
   Required impairment category: Intellectual
   Optional impairment categories: Cognitive, neurological, physical

                                                                                  Conditions – 6

SGP KP Publishing – Impairment categories guide

Spina bifida ICD 10 Codes: Q05 Required impairment category: Physical Optional impairment categories: Intellectual, cognitive, sensory, neurological
Foetal alcohol syndrome ICD 10 Codes: Q86.0 Required impairment category: Neurological Optional impairment categories: Intellectual, cognitive, sensory, physical, psychosocial
Foetal alcohol spectrum disorder (FASD) ICD 10 Codes: Q86.0D Required impairment category: Neurological Optional impairment categories: Intellectual, cognitive, sensory, physical, psychosocial
Cornelia de Lange syndrome ICD 10 Codes: Q87.1 Required impairment category: Intellectual Optional impairment categories: Cognitive, neurological, sensory, physical, psychosocial
Prader Willi syndrome ICD 10 Codes: Q87.1 Required impairment category: Intellectual Optional impairment categories: Cognitive, neurological, physical, psychosocial
Coffin-Lowry syndrome ICD 10 Codes: Q87.8 Required impairment category: Intellectual Optional impairment categories: Cognitive, neurological, sensory, physical, psychosocial
Other congenital conditions (causing intellectual disability) ICD 10 Codes: Q89 Required impairment category: Intellectual Optional impairment categories: Cognitive, neurological, sensory, physical, psychosocial
Edwards syndrome ICD 10 Codes: Q91 Required impairment category: Intellectual Optional impairment categories: Cognitive, neurological, sensory, physical, psychosocial
Patau syndrome ICD 10 Codes: Q91 Required impairment category: Intellectual Optional impairment categories: Cognitive, neurological, sensory, physical, psychosocial
Cri du Chat syndrome ICD 10 Codes: Q93.4 Required impairment category: Intellectual Optional impairment categories: Cognitive, sensory, physical
Angelman syndrome ICD 10 Codes: Q93.5 Required impairment category: Intellectual Optional impairment categories: Cognitive, sensory, physical
Other chromosomal syndromes (including Kabuki & Williams syndromes) ICD 10 Codes: Q99 Required impairment category: Intellectual Optional impairment categories: Cognitive, neurological, sensory, physical, psychosocial
Fragile X syndrome ICD 10 Codes: Q99.2 Required impairment category: Intellectual Optional impairment categories: Cognitive, neurological, sensory, physical, psychosocial
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                                                                          Conditions – 7
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SGP KP Publishing – Impairment categories guide

3.4 Cerebral Palsy

1. Cerebral palsy
  ICD 10 Codes: G80
   Required impairment category: Physical
   Optional impairment categories: Intellectual, cognitive, neurological, sensory

3.5 Down Syndrome

1. Down syndrome
  ICD 10 Codes: Q90
   Required impairment category: Intellectual
   Optional impairment categories: Cognitive, physical

3.6 Hearing Impairment

1. Hearing loss
  ICD 10 Codes: H90
   Required impairment category: Sensory
   Optional impairment categories: Cognitive
2. Congenital hearing condition
  ICD 10 Codes: Q16.9
   Required impairment category: Sensory
   Optional impairment categories: Cognitive

3.7 Visual Impairment

1. Albinism
  ICD 10 Codes: E70.3
   Required impairment category: Sensory
   Optional impairment categories: Not applicable
2. Visual impairment (including blindness)
  ICD 10 Codes: H54
   Required impairment category: Sensory
   Optional impairment categories: Not applicable
3. Congenital eye conditions
  ICD 10 Codes: Q15.9
   Required impairment category: Sensory
   Optional impairment categories: Not applicable

3.8 Other Sensory - Speech

1. Other sensory - speech
  ICD 10 Codes: R47
   Required impairment category: Sensory
   Optional impairment categories: Physical

3.9 Multiple Sclerosis

1. Multiple Sclerosis
  ICD 10 Codes: G35
   Required impairment category: Neurological
   Optional impairment categories: Cognitive, physical, psychosocial

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SGP KP Publishing – Impairment categories guide

3.10 Other Neurological

1. Alzheimer's disease
  ICD 10 Codes: F00
   Required impairment category: Cognitive
   Optional impairment categories: Neurological, physical, psychosocial
2. Unspecified dementia
  ICD 10 Codes: F03
   Required impairment category: Cognitive
   Optional impairment categories: Neurological, physical, psychosocial
3. Huntington disease
  ICD 10 Codes: G10
   Required impairment category: Physical
   Optional impairment categories: Cognitive, neurological, psychosocial
4. Motor neurone disease
  ICD 10 Codes: G12.2
   Required impairment category: Physical
   Optional impairment categories: Cognitive, neurological, sensory, psychosocial
5. Parkinson's disease
  ICD 10 Codes: G20
   Required impairment category: Neurological
   Optional impairment categories: Cognitive, physical, psychosocial
6. Epilepsy – Mandatory TAPI
  ICD 10 Codes: G40
   Required impairment category: Neurological
   Optional impairment categories: Intellectual, cognitive, psychosocial
7. Muscular dystrophy
  ICD 10 Codes: G71.0
   Required impairment category: Physical
   Optional impairment categories: Neurological
8. Other Neurological – List A and List C
  ICD 10 Codes: G99
   Required impairment category: Neurological
   Optional impairment categories: Cognitive, sensory, physical

3.11 Stroke

1. Stroke
  ICD 10 Codes: I69
   Required impairment category: Physical
   Optional impairment categories: Cognitive, neurological, sensory, psychosocial

3.12 Other Physical

1. Rheumatoid arthritis
  ICD 10 Codes: M05
   Required impairment category: Physical
   Optional impairment categories: Not applicable
2. Other arthritis – mandatory TAPI
  ICD 10 Codes: M12
   Required impairment category: Physical
   Optional impairment categories: Not applicable
3. Other physical
  ICD 10 Codes: M95
   Required impairment category: Physical
   Optional impairment categories: Psychosocial
4. Multiple traumatic amputations
  ICD 10 Codes: T05
   Required impairment category: Physical
   Optional impairment categories: Psychosocial
5. Myopathy
  ICD 10 Codes: G72.9
   Required impairment category: Physical
   Optional impairment categories: Not applicable

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SGP KP Publishing – Impairment categories guide

3.13 Psychosocial disability

1. Schizophrenia
  ICD 10 Codes: F20
   Required impairment category: Psychosocial
   Optional impairment categories: Cognitive
2. Schizoaffective disorder
  ICD 10 Codes: F25.9
   Required impairment category: Psychosocial
   Optional impairment categories: Cognitive
3. Bipolar affective disorder
  ICD 10 Codes: F31
   Required impairment category: Psychosocial
   Optional impairment categories: Cognitive
4. Major depressive illness
  ICD 10 Codes: F32
   Required impairment category: Psychosocial
   Optional impairment categories: Cognitive
5. Other anxiety disorders
  ICD 10 Codes: F41
   Required impairment category: Psychosocial
   Optional impairment categories: Cognitive
6. Obsessive-compulsive disorder
  ICD 10 Codes: F42
   Required impairment category: Psychosocial
   Optional impairment categories: Not applicable
7. Post traumatic stress disorder
  ICD 10 Codes: F43
   Required impairment category: Psychosocial
   Optional impairment categories: Cognitive
8. Borderline personality disorder
  ICD 10 Codes: F60.3
   Required impairment category: Psychosocial
   Optional impairment categories: Not applicable
9. Tourette syndrome
  ICD 10 Codes: F95.2
   Required impairment category: Neurological
   Optional impairment categories: Cognitive, physical, psychosocial
10. Other psychosocial disorders
  ICD 10 Codes: F99
   Required impairment category: Psychosocial
   Optional impairment categories: Cognitive
11. Anorexia
  ICD 10 Codes: R63
   Required impairment category: Psychosocial
   Optional impairment categories: Cognitive, physical

3.14 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
2. Spinal cord injury (complete)
  ICD 10 Codes: T09.5
   Required impairment category: Physical
   Optional impairment categories: Neurological, sensory, psychosocial
3. Spinal cord injury (incomplete)
  ICD 10 Codes: T09.7
   Required impairment category: Physical
   Optional impairment categories: Neurological, sensory, psychosocial

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SGP KP Publishing – Impairment categories guide

3.15 Other

Malignant neoplasm of brainICD 10 Codes: C71 Required impairment category: Neurological Optional impairment categories: Cognitive, psychosocial
Metastatic cancerICD 10 Codes: C79.9 Required impairment category: Physical Optional impairment categories: Cognitive
Malignant neoplasm of blood or immune diseaseICD 10 Codes: C96 Required impairment category: Physical Optional impairment categories: Cognitive
Autoimmune disordersICD 10 Codes: D89.9 Required impairment category: Physical Optional impairment categories: Cognitive
Obesity – mandatory TAPIBICD 10 Codes: E66 Required impairment category: Physical Optional impairment categories: Psychosocial
Classical phenylketonuriaICD 10 Codes: E70.0 Required impairment category: Cognitive Optional impairment categories: Psychosocial
Disorders of pyruvate metabolism and gluconeogenesisICD 10 Codes: E74.4 Required impairment category: Intellectual Optional impairment categories: Neurological, physical
Other metabolic disordersICD 10 Codes: E88 Required impairment category: Intellectual Optional impairment categories: Neurological, physical
Dementia – rapidly progressingICD 10 Codes: F03.9 Required impairment category: Cognitive Optional impairment categories: Not applicable
Functional neurological disorder (FND) – mandatory TAPIBICD 10 Codes: F44.4 Required impairment category: Neurological Optional impairment categories: Cognitive, sensory, physical
Other language disorderICD 10 Codes: F80 Required impairment category: Cognitive Optional impairment categories: Not applicable
Peripheral neuropathy – does NOT require TAPIBICD 10 Codes: F90.0 Required impairment category: Neurological Optional impairment categories: Sensory, physical
Oppositional defiant disorder (ODD)ICD 10 Codes: F91.3 Required impairment category: Cognitive Optional impairment categories: Psychosocial
Other hereditary ataxiasICD 10 Codes: G11.8 Required impairment category: Neurological Optional impairment categories: Cognitive, sensory, physical
Dementia – early onsetICD 10 Codes: G30.0 Required impairment category: Cognitive Optional impairment categories: Not applicable
PlegiaICD 10 Codes: G83.1 Required impairment category: Physical Optional impairment categories: Neurological

Conditions – 11

SGP KP Publishing – Impairment categories guide

Chronic pain – mandatory TAPIBICD 10 Codes: G89.4 Required impairment category: Physical Optional impairment categories: Sensory, psychosocial
Postural Orthostatic Tachycardia Syndrome (POTS) – mandatory TAPIBICD 10 Codes: I49.8 Required impairment category: Neurological Optional impairment categories: Physical
Lymphoedema – mandatory TAPIBICD 10 Codes: I89.0 Required impairment category: Physical Optional impairment categories: Not applicable
Chronic lung diseaseICD 10 Codes: J44.9 Required impairment category: Physical Optional impairment categories:
Chronic Obstructive Pulmonary Disease (COPD) – mandatory TAPIBICD 10 Codes: J44.9A Required impairment category: Physical Optional impairment categories: Not applicable
Osteoarthritis – mandatory TAPIBICD 10 Codes: M19.9 Required impairment category: Physical Optional impairment categories: Not applicable
Systemic lupus erythematosusICD 10 Codes: M32 Required impairment category: Physical Optional impairment categories: Not applicable
Ankylosing spondylitisICD 10 Codes: M45 Required impairment category: Physical Optional impairment categories: Not applicable
FibromyalgiaICD 10 Codes: M79.7 Required impairment category: Physical Optional impairment categories: Sensory
Renal failureICD 10 Codes: N18 Required impairment category: Physical Optional impairment categories:
Ehlers Danlos – does NOT require TAPIBICD 10 Codes: Q79.6 Required impairment category: Physical Optional impairment categories: Not applicable
DyslexiaICD 10 Codes: R48 Required impairment category: Cognitive Optional impairment categories: Psychosocial
Childhood apraxia of speechICD 10 Codes: R48.2 Required impairment category: Neurological Optional impairment categories: Cognitive
Short statureICD 10 Codes: R62.5 Required impairment category: Physical Optional impairment categories: Not applicable
Amputation – single limb or upper/lower limbICD 10 Codes: Z89 Required impairment category: Physical Optional impairment categories: Cognitive, sensory, psychosocial
Amputation – multipleICD 10 Codes: Z89.1 Required impairment category: Physical Optional impairment categories: Cognitive, sensory, psychosocial

Conditions – 12