G12.21
G12.21: Amyotrophic lateral sclerosis
Billable / specific codeICD-10-CM
G12.21 is a billable, specific ICD-10-CM code for amyotrophic lateral sclerosis. It is valid for submission on a claim.
Check G12.21 with the rest of the claim: free scrubberOther codes that can never be billed with G12.21
Their own Excludes1 notes name this code, so the conflict is not listed above.
- M62.5Muscle wasting and atrophy, not elsewhere classified
Risk adjustment
G12.21 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 190 Amyotrophic Lateral Sclerosis and Other Motor Neuron Disease, Spinal Muscular Atrophy1.175 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
G12.21 is named in 26 Medicare coverage policies: 26 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52494High Frequency Chest Wall Oscillation Devices - Policy Article
- A52510Mechanical In-exsufflation Devices - Policy Article
- A52996Billing and Coding: Routine Foot Care
- A53057Billing and Coding: Home Health Occupational Therapy
Alphabetic index entries that lead here
- Duchenne-Aran muscular atrophy
- Amyotrophia, amyotrophy, amyotrophic›lateral sclerosis
- Atrophy, atrophic›Duchenne-Aran
- Paralysis, paralytic›amyotrophic
- Sclerosis, sclerotic›amyotrophic(lateral)
- Sclerosis, sclerotic›lateral(amyotrophic) (descending) (spinal)
- Atrophy, atrophic›muscle, muscular›Duchenne-Aran
- Atrophy, atrophic›muscle, muscular›progressive(bulbar)
- Disease, diseased›motor neuron›amyotrophic lateral sclerosis
- Paralysis, paralytic›muscle, muscular NEC›progressive
- Paralysis, paralytic›spinal›progressive
- Sclerosis, sclerotic›spinal›lateral(amyotrophic)
Code history
Unchanged in every release from FY2024 to FY2027.