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v1.0.0
ICD-10 Guide
ICD-10 CodesG11.11

G11.11

Billable

Friedreich ataxia

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 G11.11 is a billable code used to indicate a diagnosis of friedreich ataxia.

Key Diagnostic Point:

Friedreich ataxia is a hereditary degenerative disease characterized by progressive ataxia, which is a lack of voluntary coordination of muscle movements. It is caused by mutations in the FXN gene, leading to reduced levels of frataxin, a protein essential for mitochondrial function. The condition typically manifests in childhood or early adulthood and is associated with symptoms such as gait and limb ataxia, loss of deep tendon reflexes, scoliosis, and sensory loss. Patients may also experience hypertrophic cardiomyopathy and diabetes mellitus. The disease progresses over time, leading to significant disability and reduced life expectancy. Diagnosis is primarily clinical, supported by genetic testing and MRI findings that may show spinal cord atrophy. Management focuses on symptomatic treatment and supportive care, including physical therapy and monitoring for cardiac complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Genetic testing documentation requirements
  • Differentiation from other ataxias
  • Potential comorbid conditions (e.g., diabetes, cardiomyopathy)
  • Variability in symptom presentation

Audit Risk Factors

  • Inadequate documentation of genetic testing results
  • Failure to document associated conditions
  • Misclassification with other types of ataxia
  • Lack of detailed clinical notes on symptom progression

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological examination findings, genetic test results, and symptom history.

Common Clinical Scenarios

Initial diagnosis of ataxia, management of progressive symptoms, and coordination of care with other specialists.

Billing Considerations

Ensure thorough documentation of neurological deficits and any referrals to genetic counseling.

Cardiology

Documentation Requirements

Cardiac evaluation results, including echocardiograms and any interventions performed.

Common Clinical Scenarios

Monitoring for hypertrophic cardiomyopathy in patients with Friedreich ataxia.

Billing Considerations

Document any cardiac symptoms and their management, as they are critical for comprehensive care.

Coding Guidelines

Inclusion Criteria

Use G11.11 When
  • Follow the ICD
  • CM coding guidelines for hereditary and degenerative diseases
  • Ensure accurate documentation of the condition's hereditary nature and any associated complications
  • Include relevant clinical findings and genetic testing results

Exclusion Criteria

Do NOT use G11.11 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

96125CPT Code

Neuropsychological testing

Clinical Scenario

Used for cognitive assessment in patients with Friedreich ataxia.

Documentation Requirements

Document the rationale for testing and results.

Specialty Considerations

Neurology specialists should ensure comprehensive cognitive evaluations.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of Friedreich ataxia, improving the accuracy of data collection and reimbursement processes. It emphasizes the importance of genetic confirmation and associated conditions.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of Friedreich ataxia, improving the accuracy of data collection and reimbursement processes. It emphasizes the importance of genetic confirmation and associated conditions.

Reimbursement & Billing Impact

reimbursement processes. It emphasizes the importance of genetic confirmation and associated conditions.

Resources

Clinical References

  • •
    National Ataxia Foundation
  • •
    Genetics Home Reference - Friedreich Ataxia

Coding & Billing References

  • •
    National Ataxia Foundation
  • •
    Genetics Home Reference - Friedreich Ataxia

Frequently Asked Questions

What is the primary cause of Friedreich ataxia?

Friedreich ataxia is primarily caused by mutations in the FXN gene, which leads to reduced levels of frataxin, affecting mitochondrial function.

How is Friedreich ataxia diagnosed?

Diagnosis is made through clinical evaluation, family history, and genetic testing to confirm mutations in the FXN gene.