G71.0341
BillableLimb girdle muscular dystrophy due to alpha sarcoglycan dysfunction
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is G71.0341 an HCC code?
Yes. G71.0341 maps to Muscular Dystrophy under the CMS-HCC V28 risk adjustment model (and Muscular Dystrophy under V24).
HCC Category Mapping
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 G71.0341
For G71.0341 to 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 G71.0341 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
G71.0341 is the ICD-10-CM diagnosis code for limb girdle muscular dystrophy due to alpha sarcoglycan dysfunction. A genetic muscle weakness disorder affecting the hip and shoulder muscles caused by dysfunction of alpha sarcoglycan, a protein that helps stabilize muscle cell membranes. G71.0341 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, G71.0341 maps to Muscular Dystrophy (HCC 197) with a community, non-dual, aged base RAF weight of 0.000. Under the older V24 model, G71.0341 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.
Confirm alpha sarcoglycan gene mutation or protein deficiency through genetic testing or muscle biopsy. Because G71.0341 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 G71.0341 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Confirm alpha sarcoglycan gene mutation or protein deficiency through genetic testing or muscle biopsy
- •Document the inheritance pattern (autosomal recessive is most common) when available
Clinical Significance
Limb girdle muscular dystrophy due to alpha sarcoglycan dysfunction (LGMD2D/LGMDR3) is the most common sarcoglycanopathy, often presenting in childhood with severe proximal weakness. Alpha-sarcoglycan deficiency can mimic Duchenne muscular dystrophy in severity. Precise coding enables genetic counseling, potential gene therapy eligibility, and accurate representation of disease complexity for risk adjustment.
Documentation Requirements
- ✓Genetic testing confirming SGCA gene mutation or muscle biopsy showing absent/reduced alpha-sarcoglycan
- ✓Clinical presentation: childhood-onset progressive proximal weakness, elevated creatine kinase
- ✓Cardiac evaluation (alpha-sarcoglycanopathy can cause cardiomyopathy)
- ✓Respiratory function assessment
- ✓Functional status: ambulation, activities of daily living
- ✓Family history consistent with autosomal recessive inheritance
Commonly Confused Codes
- •G71.0340 — Limb girdle muscular dystrophy due to sarcoglycan dysfunction, unspecified should not be used when alpha subtype is confirmed
- •G71.0342 — Beta sarcoglycan dysfunction involves a different sarcoglycan protein
- •G71.01 — Duchenne muscular dystrophy involves dystrophin, not sarcoglycan, despite similar clinical severity
- •G71.039 — Limb girdle muscular dystrophy, unspecified is overly broad when the specific protein is identified