Is G72.4 a billable ICD-10-CM code?

No. G72.4 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does G72.4 sit in the tabular list?

Diseases of the nervous system (G00-G99), in the block Diseases of myoneural junction and muscle (G70-G73).

What cannot be coded together with G72.4?

G72.4 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above G72.4 (G72) and apply to it just the same.

G72.4

G72.4 — Inflammatory and immune myopathies, not elsewhere classified

Non-billable headerICD-10-CM

G72.4 is a non-billable header ICD-10-CM code for inflammatory and immune myopathies, not elsewhere classified. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1 inherited from the categories above G72.4

These are not written on G72.4, but they bind it: a note on a category applies to every code beneath it. Billing G72.4 with anything listed here is a denial.

Written on G72 — Other and unspecified myopathies

arthrogryposis multiplex congenita (Q74.3)
dermatopolymyositis (M33.-)
ischemic infarction of muscle (M62.2-)
myositis (M60.-)
polymyositis (M33.2.-)

Risk adjustment

G72.4 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Code history

G72.4 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Code to one of these instead G72.4

2 child codes. Green means billable.

Related codes at this level

Codes that share G72. If G72.4 is not quite right, the correct code is usually one of these.

Questions about G72.4

Is G72.4 a billable ICD-10-CM code?: No. G72.4 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does G72.4 sit in the tabular list?: Diseases of the nervous system (G00-G99), in the block Diseases of myoneural junction and muscle (G70-G73).
What cannot be coded together with G72.4?: G72.4 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above G72.4 (G72) and apply to it just the same.