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ICD-10 Guide
ICD-10 CodesG11.5

G11.5

Billable

Hypomyelination - hypogonadotropic hypogonadism - hypodontia

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

Code Description

ICD-10 G11.5 is a billable code used to indicate a diagnosis of hypomyelination - hypogonadotropic hypogonadism - hypodontia.

Key Diagnostic Point:

G11.5 refers to a rare genetic disorder characterized by hypomyelination, which is the inadequate formation of myelin sheaths around nerve fibers, leading to neurological deficits. This condition is often associated with hypogonadotropic hypogonadism, a form of hypogonadism resulting from insufficient gonadotropin release from the pituitary gland, leading to underdeveloped sexual characteristics and reproductive issues. Additionally, hypodontia, the congenital absence of one or more teeth, is frequently observed in individuals with this syndrome. The interplay of these three conditions can lead to a complex clinical picture, often requiring multidisciplinary management. Patients may present with developmental delays, motor coordination difficulties, and endocrine abnormalities. Genetic testing is crucial for diagnosis, as these conditions can be part of broader hereditary syndromes, including certain types of ataxias and other degenerative diseases. Understanding the pathophysiology and clinical manifestations is essential for effective management and coding.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Multisystem involvement requiring comprehensive documentation.
  • Potential overlap with other hereditary and degenerative diseases.
  • Need for genetic testing results for accurate diagnosis.
  • Variability in clinical presentation among affected individuals.

Audit Risk Factors

  • Inadequate documentation of all three components (hypomyelination, hypogonadotropic hypogonadism, hypodontia).
  • Failure to provide genetic testing results.
  • Misalignment between clinical findings and coded diagnosis.
  • Inconsistent use of terminology in medical records.

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological assessments, imaging studies, and genetic testing results.

Common Clinical Scenarios

Patients presenting with motor coordination issues, developmental delays, and neurological deficits.

Billing Considerations

Ensure comprehensive documentation of neurological findings and any associated conditions.

Endocrinology

Documentation Requirements

Hormonal assessments, growth and development evaluations, and reproductive health documentation.

Common Clinical Scenarios

Patients with delayed puberty, infertility issues, and other endocrine abnormalities.

Billing Considerations

Document hormonal levels and any treatments provided for hypogonadism.

Coding Guidelines

Inclusion Criteria

Use G11.5 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of all components of the syndrome
  • Include any relevant genetic testing results and multidisciplinary notes to support the diagnosis

Exclusion Criteria

Do NOT use G11.5 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

83001CPT Code

Testosterone, total

Clinical Scenario

Used to evaluate hypogonadism in patients with G11.5.

Documentation Requirements

Document the reason for testing and any relevant clinical findings.

Specialty Considerations

Endocrinology should provide comprehensive hormonal assessments.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of complex conditions like G11.5, improving the accuracy of diagnoses and facilitating better patient management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of complex conditions like G11.5, improving the accuracy of diagnoses and facilitating better patient management.

Reimbursement & Billing Impact

reimbursement and avoiding audits.

Resources

Clinical References

  • •
    Genetic and Rare Diseases Information Center

Coding & Billing References

  • •
    Genetic and Rare Diseases Information Center

Frequently Asked Questions

What are the primary symptoms of G11.5?

The primary symptoms include neurological deficits due to hypomyelination, reproductive issues due to hypogonadotropic hypogonadism, and dental anomalies such as hypodontia.