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v1.0.0
ICD-10 Guide
ICD-10 CodesG71.0342

G71.0342

Billable

Limb girdle muscular dystrophy due to beta sarcoglycan dysfunction

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

Code Description

ICD-10 G71.0342 is a billable code used to indicate a diagnosis of limb girdle muscular dystrophy due to beta sarcoglycan dysfunction.

Key Diagnostic Point:

Limb girdle muscular dystrophy (LGMD) due to beta sarcoglycan dysfunction is a genetic disorder characterized by progressive weakness and wasting of the proximal muscles, particularly those around the hips and shoulders. This condition is caused by mutations in the gene responsible for producing beta sarcoglycan, a protein that plays a crucial role in maintaining muscle cell integrity. Patients typically present with muscle weakness that may begin in childhood or adolescence, often leading to difficulty in walking, climbing stairs, and performing daily activities. As the disease progresses, individuals may experience muscle atrophy and may require mobility aids. Diagnosis is confirmed through genetic testing, muscle biopsy, and clinical evaluation. Management focuses on supportive care, physical therapy, and monitoring for complications such as respiratory issues and scoliosis. Understanding the genetic basis of this condition is essential for counseling families and considering potential future therapies, including gene therapy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of genetic testing results
  • Differentiation from other muscular dystrophies
  • Need for precise documentation of muscle weakness patterns
  • Potential for co-morbid conditions affecting coding

Audit Risk Factors

  • Inadequate documentation of genetic testing results
  • Failure to specify the type of muscular dystrophy
  • Misclassification of muscle weakness severity
  • Lack of comprehensive patient history

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological examination findings, genetic testing results, and muscle biopsy reports.

Common Clinical Scenarios

Patients presenting with progressive muscle weakness, difficulty in mobility, and family history of muscular dystrophy.

Billing Considerations

Ensure accurate documentation of muscle groups affected and progression of symptoms.

Genetics

Documentation Requirements

Genetic test results, family history, and counseling notes.

Common Clinical Scenarios

Families seeking genetic counseling after a diagnosis of LGMD.

Billing Considerations

Documentation should include the implications of genetic findings for family members.

Coding Guidelines

Inclusion Criteria

Use G71.0342 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used only when there is confirmed beta sarcoglycan dysfunction
  • Document all relevant clinical findings and genetic testing results to support the diagnosis

Exclusion Criteria

Do NOT use G71.0342 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

81406CPT Code

Genetic testing for muscular dystrophy

Clinical Scenario

Used when confirming a diagnosis of LGMD due to beta sarcoglycan dysfunction.

Documentation Requirements

Documentation of clinical findings and rationale for genetic testing.

Specialty Considerations

Neurology and genetics specialists should ensure comprehensive documentation to support testing.

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, including G71.0342, which enhances the ability to track and manage these conditions effectively. This specificity aids in research, treatment planning, and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of muscular dystrophies, including G71.0342, which enhances the ability to track and manage these conditions effectively. This specificity aids in research, treatment planning, and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    Muscular Dystrophy Association

Coding & Billing References

  • •
    Muscular Dystrophy Association

Frequently Asked Questions

What is the significance of beta sarcoglycan in muscular dystrophy?

Beta sarcoglycan is a critical protein for muscle cell membrane stability. Dysfunction leads to muscle degeneration and weakness characteristic of limb girdle muscular dystrophy.