Neurology & Pain Management Coding Alert

Neurology & Pain Management Coding:

Scour Inclusion Terms Before Settling on ‘Other’ MD Dx

Question: Encounter notes indicate that the physician treated a patient with “Emry-Dreyfuss MD.” I’m pretty sure the patient has muscular dystrophy (MD), but I don’t see a diagnosis for this type of MD. Should I report G71.00 for this patient?

Oklahoma Subscriber

Answer: You should report G71.09 (Other specified muscular dystrophies) for this patient’s MD. Although the spelling is incorrect, the physician does specify the MD. Further, it is listed as an inclusion term for G71.09, under the title “Benign scapuloperoneal muscular dystrophy with early contractures [Emery-Dreifuss].”

To report G71.09, the physician only has to specify the type of MD; it doesn’t matter if it’s listed in the inclusion terms beneath the code descriptor. If the physician doesn’t specify the type of MD, you should report G71.00 (Muscular dystrophy, unspecified).

Hands of a disabled person with muscular dystrophy holding a ventilator for deep breathing, concept, background

Best bet: Before settling on G71.00, you would be wise to look at all of the inclusion terms under every MD entry in the ICD-10-CM code book as there are a lot of them. For example, these are the inclusion terms beneath G71.0349 (Limb girdle muscular dystrophy due to other sarcoglycan dysfunction):

  • Delta sarcoglycanopathy
  • Delta-sarcoglycan-related LGMD R6
  • Gamma sarcoglycanopathy
  • Gamma-sarcoglycan-related LGMD R5
  • Limb girdle muscular dystrophy type 2C
  • Limb girdle muscular dystrophy type 2F

If you reported G71.00 and the physician listed one of the above diagnoses for the patient, it would be incorrect coding.

Chris Boucher, MS, CPC, Senior Development Editor, AAPC