Is ICD-10-CM code G72 billable?

No, G72 (Other and unspecified myopathies) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code G72 belong to?

G72 belongs to Chapter 6 of the ICD-10-CM tabular list: G00–G99 (Diseases of the Nervous System).

G72Not billable, use a more specific code below

Other and unspecified myopathies

In Diseases of myoneural junction and muscle (G70-G73), chapter 6: Diseases of the Nervous System

9 billable codes under G72: 4 are a CC; 1 map to HCC 93 (Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders).A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment. An HCC counts toward a Medicare Advantage patient's risk score.

Instructional notes

Excludes1: not coded here, use a different code

arthrogryposis multiplex congenita (Q74.3)
dermatopolymyositis (M33.-)
ischemic infarction of muscle (M62.2-)
myositis (M60.-)
polymyositis (M33.2.-)

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Covers default dominant or nondominant side for hemiplegia and monoplegia, and use and sequencing of G89 pain codes, including postoperative, chronic, and neoplasm-related pain.

Dominant/nondominant side (page 45)
Pain - Category G89 (page 45)

Read Section I.C.6 (page 45)

All codes under G72

G72 can't be used on a claim. Pick a billable code below; grey headings group them.

G72 MS-DRGs

As the principal diagnosis, the billable codes under G72 group to MS-DRG 091, 092, 093, 545, 546, or 547 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 091 Other Disorders of Nervous System with MCC (7 of 9 codes)
DRG 092 Other Disorders of Nervous System with CC (7 of 9 codes)
DRG 093 Other Disorders of Nervous System without CC/MCC (7 of 9 codes)
DRG 545 Connective Tissue Disorders with MCC (2 of 9 codes)
DRG 546 Connective Tissue Disorders with CC (2 of 9 codes)
DRG 547 Connective Tissue Disorders without CC/MCC (2 of 9 codes)

Other codes that refer to G72

Notes on these codes point to G72.

M60-M63 Excludes2: muscular dystrophies and myopathies (G71-G72)
M62.84 Code First: other and unspecified myopathies (G72.-)

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Muscle Disorders

Your muscles help you move and help your body work. Different types of muscles have different jobs. There are many problems that can affect muscles. Muscle disorders can cause weakness, pain or even paralysis.

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.