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v1.0.0
ICD-10 Guide
ICD-10 CodesG72.1

G72.1

Billable

Alcoholic myopathy

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

Code Description

ICD-10 G72.1 is a billable code used to indicate a diagnosis of alcoholic myopathy.

Key Diagnostic Point:

Alcoholic myopathy is a muscle disorder associated with chronic alcohol consumption, characterized by muscle weakness and atrophy. It primarily affects skeletal muscle and can present with symptoms such as muscle pain, tenderness, and weakness, particularly in the proximal muscles. The condition is thought to result from the toxic effects of alcohol on muscle fibers, leading to degeneration and impaired muscle function. Diagnosis is typically made through clinical evaluation, patient history, and laboratory tests, including serum creatine kinase levels, which may be elevated. Muscle biopsy may also be performed to confirm the diagnosis and rule out other myopathies. Alcoholic myopathy can occur in individuals with varying levels of alcohol consumption, but it is more prevalent in those with a history of heavy drinking. Treatment focuses on abstinence from alcohol, nutritional support, and physical therapy to improve muscle strength and function. Recovery can be variable, with some patients experiencing significant improvement while others may have persistent weakness.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating from other myopathies and neuromuscular disorders.
  • Need for comprehensive patient history regarding alcohol use.
  • Potential overlap with conditions like myasthenia gravis and muscular dystrophies.
  • Variability in clinical presentation and severity among patients.

Audit Risk Factors

  • Inadequate documentation of alcohol consumption history.
  • Failure to document associated symptoms or complications.
  • Misclassification of the condition as a different myopathy.
  • Lack of supporting lab results or imaging studies.

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological examination findings, history of alcohol use, and any associated symptoms.

Common Clinical Scenarios

Patients presenting with muscle weakness and a history of alcohol abuse.

Billing Considerations

Consideration of differential diagnoses such as myasthenia gravis and other neuromuscular junction disorders.

Physical Medicine and Rehabilitation

Documentation Requirements

Assessment of functional status, rehabilitation goals, and progress notes.

Common Clinical Scenarios

Patients undergoing rehabilitation for muscle weakness due to alcohol-related myopathy.

Billing Considerations

Focus on functional improvement and the impact of alcohol cessation on recovery.

Coding Guidelines

Inclusion Criteria

Use G72.1 When
  • According to ICD
  • 10 guidelines, G72
  • 1 should be used when the myopathy is specifically attributed to alcohol use
  • It is important to document the duration and amount of alcohol consumption, as well as any other contributing factors

Exclusion Criteria

Do NOT use G72.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used for follow-up visits for patients with alcoholic myopathy.

Documentation Requirements

Document history of present illness, review of systems, and physical exam findings.

Specialty Considerations

Neurology or PM&R specialists should focus on functional assessments.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of alcoholic myopathy, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of alcoholic myopathy, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the primary cause of alcoholic myopathy?

The primary cause of alcoholic myopathy is chronic alcohol consumption, which leads to muscle fiber degeneration and impaired muscle function.