G71.036 ICD-10-CM Code: Limb girdle muscular dystrophy due to fukutin related protein dysfunction

G71.036 is the ICD-10-CM diagnosis code for limb girdle muscular dystrophy due to fukutin related protein dysfunction. This is a rare inherited muscle disease where the muscles around the hips and shoulders gradually weaken and waste away due to a defect in a protein called fukutin-related protein. It's a genetic condition that affects muscle function and strength over time. G71.036 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, G71.036 maps to Muscular Dystrophy (HCC 197) with a source-labeled community, non-dual, aged reference coefficient of 0.426. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

This code requires documentation of the specific type of limb girdle muscular dystrophy (LGMD) with confirmed fukutin-related protein dysfunction; genetic testing results should be referenced in the medical record. For G71.036, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.