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ICD-10 Guide
ICD-10 CodesChapter 6: Diseases of the nervous systemG11

G11

Billable

Hereditary ataxia

Chapter 6:Diseases of the nervous system

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

Code Description

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

Key Diagnostic Point:

Hereditary ataxia refers to a group of genetic disorders characterized by progressive loss of coordination and balance due to degeneration of the cerebellum and its connections. These conditions can be inherited in various patterns, including autosomal dominant, autosomal recessive, and X-linked inheritance. The clinical presentation often includes gait disturbances, dysarthria, and oculomotor dysfunction. Patients may also experience associated symptoms such as spasticity, sensory loss, and cognitive decline, depending on the specific type of ataxia. Common forms of hereditary ataxia include Friedreich's ataxia, spinocerebellar ataxias (SCAs), and ataxia-telangiectasia. Diagnosis typically involves a combination of clinical evaluation, family history assessment, genetic testing, and neuroimaging studies. Management focuses on symptomatic relief and supportive care, as there is currently no cure for these degenerative conditions. Understanding the genetic basis of hereditary ataxia is crucial for accurate diagnosis and potential future therapies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of hereditary ataxias with different genetic causes
  • Need for precise documentation of family history
  • Potential overlap with other neurodegenerative disorders
  • Variability in clinical presentation among patients

Audit Risk Factors

  • Inadequate documentation of genetic testing results
  • Failure to document family history of ataxia
  • Misclassification of ataxia type
  • Lack of detailed clinical notes on symptoms

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Comprehensive neurological examination findings, family history, and results of genetic testing.

Common Clinical Scenarios

Patients presenting with progressive ataxia, gait disturbances, and associated neurological symptoms.

Billing Considerations

Ensure clarity in documenting the specific type of hereditary ataxia and any associated conditions.

Genetics

Documentation Requirements

Detailed family pedigree, genetic test results, and interpretation of findings.

Common Clinical Scenarios

Patients referred for genetic counseling due to family history of ataxia.

Billing Considerations

Accurate coding requires understanding of the genetic basis and inheritance patterns.

Coding Guidelines

Inclusion Criteria

Use G11 When
  • 10 coding guidelines for G11 include accurate documentation of the hereditary nature of the ataxia, specific type if known, and any associated conditions

Exclusion Criteria

Do NOT use G11 When
  • Exclusion criteria involve differentiating hereditary ataxia from acquired forms of ataxia

Related CPT Codes

96116CPT Code

Neuropsychological testing

Clinical Scenario

Used for assessing cognitive function in patients with hereditary ataxia.

Documentation Requirements

Document the rationale for testing and results.

Specialty Considerations

Neurologists should ensure comprehensive cognitive assessments are included.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of hereditary ataxias, improving the accuracy of data collection and reimbursement processes. It has also facilitated better tracking of these conditions for research and treatment purposes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of hereditary ataxias, improving the accuracy of data collection and reimbursement processes. It has also facilitated better tracking of these conditions for research and treatment purposes.

Reimbursement & Billing Impact

reimbursement processes. It has also facilitated better tracking of these conditions for research and treatment purposes.

Resources

Clinical References

  • •
    National Ataxia Foundation

Coding & Billing References

  • •
    National Ataxia Foundation

Frequently Asked Questions

What is the difference between hereditary ataxia and acquired ataxia?

Hereditary ataxia is caused by genetic mutations passed through families, while acquired ataxia results from external factors such as stroke, alcohol abuse, or vitamin deficiencies.