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v1.0.0
ICD-10 Guide
ICD-10 CodesG71.01

G71.01

Billable

Duchenne or Becker muscular dystrophy

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

Code Description

ICD-10 G71.01 is a billable code used to indicate a diagnosis of duchenne or becker muscular dystrophy.

Key Diagnostic Point:

Duchenne and Becker muscular dystrophies are genetic disorders characterized by progressive muscle degeneration and weakness due to mutations in the dystrophin gene located on the X chromosome. Duchenne muscular dystrophy (DMD) is the more severe form, typically presenting in early childhood, with symptoms such as delayed motor milestones, muscle weakness, and pseudohypertrophy of the calves. Becker muscular dystrophy (BMD) is a milder variant that usually manifests later in life and progresses more slowly. Both conditions primarily affect males, as they are X-linked recessive disorders. The absence or deficiency of dystrophin disrupts the integrity of muscle cell membranes, leading to muscle fiber damage and eventual replacement with fibrous and adipose tissue. Diagnosis is often confirmed through genetic testing, muscle biopsy, and clinical evaluation. Management focuses on maintaining mobility, preventing complications, and addressing associated cardiac and respiratory issues.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Genetic testing documentation requirements
  • Differentiation between Duchenne and Becker types
  • Need for multidisciplinary care documentation
  • Potential for comorbid conditions affecting coding

Audit Risk Factors

  • Inadequate documentation of genetic testing results
  • Failure to specify the type of muscular dystrophy
  • Lack of multidisciplinary care notes
  • Incorrect linkage of symptoms to the diagnosis

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological assessments, genetic testing results, and treatment plans.

Common Clinical Scenarios

Diagnosis confirmation, management of muscle weakness, and monitoring of progression.

Billing Considerations

Ensure accurate documentation of muscle strength assessments and functional abilities.

Genetics

Documentation Requirements

Genetic testing results, family history, and counseling notes.

Common Clinical Scenarios

Genetic counseling for families, interpretation of genetic tests, and risk assessment.

Billing Considerations

Document the specific mutations identified and their implications for family members.

Coding Guidelines

Inclusion Criteria

Use G71.01 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the diagnosis, including the type of muscular dystrophy
  • Include any relevant genetic testing results and associated conditions

Exclusion Criteria

Do NOT use G71.01 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

81401CPT Code

Genetic testing for dystrophin gene mutations

Clinical Scenario

Used for confirming diagnosis of Duchenne or Becker muscular dystrophy.

Documentation Requirements

Document the reason for testing and results.

Specialty Considerations

Neurology and genetics must coordinate documentation.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of muscular dystrophies, improving the accuracy of data collection and reimbursement processes. G71.01 provides a clear distinction between Duchenne and Becker types, which is essential for appropriate management and research.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of muscular dystrophies, improving the accuracy of data collection and reimbursement processes. G71.01 provides a clear distinction between Duchenne and Becker types, which is essential for appropriate management and research.

Reimbursement & Billing Impact

reimbursement processes. G71.01 provides a clear distinction between Duchenne and Becker types, which is essential for appropriate management and research.

Resources

Clinical References

  • •
    Muscular Dystrophy Association

Coding & Billing References

  • •
    Muscular Dystrophy Association

Frequently Asked Questions

What is the difference between Duchenne and Becker muscular dystrophy?

Duchenne muscular dystrophy is characterized by an earlier onset and more severe symptoms, while Becker muscular dystrophy has a later onset and milder progression. Both are caused by mutations in the dystrophin gene.