G72.81 — Critical illness myopathy
G72.81 is a billable, specific ICD-10-CM code for critical illness myopathy. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Acute necrotizing myopathy
- Acute quadriplegic myopathy
- Intensive care (ICU) myopathy
- Myopathy of critical illness
Excludes1 inherited from the categories above G72.81
These are not written on G72.81, but they bind it: a note on a category applies to every code beneath it. Billing G72.81 with anything listed here is a denial.
Risk adjustment
G72.81 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.
Medicare coverage
G72.81 is named in 17 Medicare coverage policies — 17 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A53057Billing and Coding: Home Health Occupational Therapy
- A53064Billing and Coding: Outpatient Occupational Therapy
- A54095Billing and Coding: Nerve Conduction Studies and Electromyography
- A54095Billing and Coding: Nerve Conduction Studies and Electromyography
How G72.81 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to G72.81.
- Myopathy›critical illness
- Myopathy›intensive care(ICU)
- Myopathy›of critical illness
- Myopathy›acute›necrotizing
- Myopathy›acute›quadriplegic
Code history
G72.81 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share G72.8. If G72.81 is not quite right, the correct code is usually one of these.
Questions about G72.81
- Is G72.81 a billable ICD-10-CM code?
- Yes. G72.81 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does G72.81 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 G72.81?
- G72.81 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 G72.81 (G72) and apply to it just the same.