G11.5

G11.5: Hypomyelination - hypogonadotropic hypogonadism - hypodontia

Billable / specific codeICD-10-CM

G11.5 is a billable, specific ICD-10-CM code for hypomyelination - hypogonadotropic hypogonadism - hypodontia. It is valid for submission on a claim.

Check G11.5 with the rest of the claim: free scrubber

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

4H syndrome
Pol III-related leukodystrophy

Excludes2 inherited from the categories above G11.5

Not part of this code, but both may be coded when both are present.

Written on G11: Hereditary ataxia

cerebral palsy (G80.-)
hereditary and idiopathic neuropathy (G60.-)
metabolic disorders (E70-E88)

Other codes that can never be billed with G11.5

Their own Excludes1 notes name this code, so the conflict is not listed above.

R26Abnormalities of gait and mobility
R27Other lack of coordination

Risk adjustment

G11.5 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 200 Friedreich and Other Hereditary Ataxias; Huntington Disease0.279 RAF

Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.

Medicare coverage

G11.5 is named in 1 Medicare coverage policy: 1 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A56641Billing and Coding: Home Health Skilled Nursing Care-Teaching and Training: Alzheimer's Disease and Behavioral Disturbances