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G71.033 ICD-10-CM Code: Limb girdle muscular dystrophy due to dysferlin dysfunction

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FY 2026 Apr update / Diseases of the nervous system (G00-G99) / Diseases of myoneural junction and muscle (G70-G73)

G71.033

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Limb girdle muscular dystrophy due to dysferlin dysfunction

A genetic muscle weakness disorder affecting the hip and shoulder muscles caused by dysferlin protein dysfunction, which helps stabilize muscle cell membranes.

Buddy the Bee presenting code insight

Buddy Insight

Limb girdle muscular dystrophy due to dysferlin dysfunction (LGMD2B/LGMDR2, also known as dysferlinopathy or Miyoshi myopathy) affects muscle membrane repair, leading to progressive proximal and sometimes distal weakness.

CMS-HCC V28

HCC 197

RAF 0.0

CMS-HCC V24

HCC 76

RAF 0.358

ACA/HHS

0

0

RAF 0

ESRD/PACE

HCC 76

RAF 0.0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
G71.0Muscular dystrophy
G71.03Limb girdle muscular dystrophies
G71.033Limb girdle muscular dystrophy due to dysferlin dysfunction

Inclusion Terms

Official
  • Dysferlinopathy
  • LGMD R2 dysferlin-related
  • Limb girdle muscular dystrophy type 2B
  • Miyoshi Myopathy type 1

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for G71.033 in this effective period.

Related Child Codes

Official
G71.031Autosomal dominant limb girdle muscular dystrophy
G71.032Autosomal recessive limb girdle muscular dystrophy due to calpain-3 dysfunction
G71.034Limb girdle muscular dystrophy due to sarcoglycan dysfunction
G71.035Limb girdle muscular dystrophy due to anoctamin-5 dysfunction
G71.036Limb girdle muscular dystrophy due to fukutin related protein dysfunction

Includes

Official

ICD-10-CM does not list Includes notes for G71.033 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for G71.033 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for G71.033 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for G71.033 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for G71.033 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Genetic testing confirming DYSF gene mutation or muscle biopsy showing absent/reduced dysferlin
Clinical presentation: proximal weakness, possible distal involvement, elevated creatine kinase
Age of onset documentation (typically late teens to young adulthood)
Functional assessment: ambulatory status, specific muscle groups affected

MEAT Support

HCC Buddy guidance
Genetic testing confirming DYSF gene mutation or muscle biopsy showing absent/reduced dysferlin
Clinical presentation: proximal weakness, possible distal involvement, elevated creatine kinase
Age of onset documentation (typically late teens to young adulthood)
Functional assessment: ambulatory status, specific muscle groups affected

Audit Caution

HCC Buddy guidance
Not recognizing that dysferlinopathy can present as Miyoshi myopathy with distal weakness, which may be mistaken for a non-dystrophic condition
Using the unspecified limb girdle code when genetic testing has confirmed dysferlin mutation
Confusing with calpain-3 dysfunction due to overlapping clinical features
Failing to update coding when genetic results return confirming the specific subtype

Common Mistakes

HCC Buddy guidance
G71.032 — Limb girdle muscular dystrophy due to calpain-3 dysfunction has similar proximal weakness but different protein deficiency
G71.0340 — Limb girdle muscular dystrophy due to sarcoglycan dysfunction involves a different structural protein
G71.039 — Limb girdle muscular dystrophy, unspecified should not be used when dysferlin mutation is confirmed
G71.09 — Other specified muscular dystrophies is less specific

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is G71.033 an HCC code?

Yes. G71.033 maps to Muscular Dystrophy under the CMS-HCC V28 risk adjustment model (and Muscular Dystrophy under V24).

HCC Category Mapping

V28HCC 197, Muscular Dystrophy
0.000
V24HCC 76, Muscular Dystrophy
0.358
ESRDHCC 76, Muscular Dystrophy
0.000

RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

MEAT Criteria for G71.033

For G71.033to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

  • MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
  • EEvaluate: test results, medication response, or physical findings reviewed by the provider
  • AAssess: explicit mention in the assessment or plan with acknowledgment of status
  • TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed G71.033 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

G71.033 is the ICD-10-CM diagnosis code for limb girdle muscular dystrophy due to dysferlin dysfunction. A genetic muscle weakness disorder affecting the hip and shoulder muscles caused by dysferlin protein dysfunction, which helps stabilize muscle cell membranes. G71.033 sits in the ICD-10-CM chapter for diseases of the nervous system (g00-g99), within the section covering diseases of myoneural junction and muscle (g70-g73).

Under the CMS-HCC V28 risk adjustment model, G71.033 maps to Muscular Dystrophy (HCC 197) with a community, non-dual, aged base RAF weight of 0.000. Under the older V24 model, G71.033 mapped to the same category but with a base RAF weight of 0.358, V28 recalibrated weights across the entire model. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.

Verify dysferlin gene mutation or protein deficiency through genetic or muscle biopsy testing. Because G71.033 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for G71.033 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Verify dysferlin gene mutation or protein deficiency through genetic or muscle biopsy testing
  • Note that dysferlin-related disorders can present with variable severity and age of onset

Clinical Significance

Limb girdle muscular dystrophy due to dysferlin dysfunction (LGMD2B/LGMDR2, also known as dysferlinopathy or Miyoshi myopathy) affects muscle membrane repair, leading to progressive proximal and sometimes distal weakness. It is unique among muscular dystrophies in that it can present with distal weakness initially. Accurate coding supports genetic counseling, potential therapeutic trial eligibility, and appropriate risk adjustment.

Documentation Requirements

  • Genetic testing confirming DYSF gene mutation or muscle biopsy showing absent/reduced dysferlin
  • Clinical presentation: proximal weakness, possible distal involvement, elevated creatine kinase
  • Age of onset documentation (typically late teens to young adulthood)
  • Functional assessment: ambulatory status, specific muscle groups affected
  • Family history and inheritance pattern (autosomal recessive)
  • Provider's explicit diagnosis specifying dysferlin dysfunction

Commonly Confused Codes

  • G71.032: Limb girdle muscular dystrophy due to calpain-3 dysfunction has similar proximal weakness but different protein deficiency
  • G71.0340: Limb girdle muscular dystrophy due to sarcoglycan dysfunction involves a different structural protein
  • G71.039: Limb girdle muscular dystrophy, unspecified should not be used when dysferlin mutation is confirmed
  • G71.09: Other specified muscular dystrophies is less specific

Child Codes

Code Hierarchy

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