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v1.0.0
ICD-10 Guide
ICD-10 CodesG71.2

G71.2

Billable

Congenital myopathies

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

Code Description

ICD-10 G71.2 is a billable code used to indicate a diagnosis of congenital myopathies.

Key Diagnostic Point:

Congenital myopathies are a group of inherited muscle disorders characterized by muscle weakness and dysfunction due to structural abnormalities in muscle fibers. These conditions are present at birth or develop in early childhood and can vary significantly in severity and clinical presentation. Congenital myopathies include a range of disorders such as nemaline myopathy, central core disease, and congenital fiber type disproportion. Patients may present with hypotonia, delayed motor milestones, and muscle weakness. Diagnosis typically involves clinical evaluation, electromyography (EMG), muscle biopsy, and genetic testing. Management focuses on supportive care, physical therapy, and addressing specific symptoms. The prognosis varies widely depending on the specific type of myopathy and the extent of muscle involvement. Early diagnosis and intervention are crucial for optimizing outcomes and improving quality of life.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of congenital myopathies with different clinical presentations.
  • Need for precise documentation of symptoms and diagnostic tests.
  • Potential overlap with other neuromuscular disorders.
  • Variability in genetic testing results and interpretations.

Audit Risk Factors

  • Inadequate documentation of specific myopathy type.
  • Failure to include genetic testing results.
  • Misclassification of congenital myopathy as acquired.
  • Lack of detailed clinical history.

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological examination findings, genetic test results, and treatment plans.

Common Clinical Scenarios

Diagnosis of congenital myopathy in infants presenting with hypotonia.

Billing Considerations

Ensure accurate documentation of muscle biopsy results and EMG findings.

Pediatrics

Documentation Requirements

Growth and developmental milestones, family history of neuromuscular disorders.

Common Clinical Scenarios

Monitoring and management of congenital myopathy in children.

Billing Considerations

Documenting multidisciplinary care approaches, including physical therapy.

Coding Guidelines

Inclusion Criteria

Use G71.2 When
  • Follow ICD
  • CM coding guidelines for specificity in documenting congenital myopathies
  • Ensure to include any relevant genetic testing and clinical findings

Exclusion Criteria

Do NOT use G71.2 When
  • Exclude conditions that are not congenital in nature

Related ICD-10 Codes

Related CPT Codes

Muscle biopsyCPT Code

Muscle biopsy for diagnostic evaluation

Clinical Scenario

Used to confirm diagnosis of congenital myopathy.

Documentation Requirements

Document indication for biopsy and results.

Specialty Considerations

Neurology or pathology specialties may be involved.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of congenital myopathies, improving the ability to capture the nuances of these conditions and their management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital myopathies, improving the ability to capture the nuances of these conditions and their management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of congenital myopathies, improving the ability to capture the nuances of these conditions and their management.

Resources

Clinical References

  • •
    Congenital Myopathies Overview

Coding & Billing References

  • •
    Congenital Myopathies Overview

Frequently Asked Questions

What are the common types of congenital myopathies?

Common types include nemaline myopathy, central core disease, and congenital fiber type disproportion, each with distinct clinical features and genetic causes.