What is ICD-10 code G71.038?

G71.038 is the ICD-10-CM diagnosis code for Other limb girdle muscular dystrophy. A genetic muscle weakness disorder affecting the hip and shoulder muscles caused by a known genetic defect other than those specifically listed in the classification system. G71.038 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. G71.038 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. G71.038 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. G71.038 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for G71.038?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For G71.038, V28 maps to Muscular Dystrophy at RAF 0.000 while V24 mapped to Muscular Dystrophy at RAF 0.358. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting G71.038?

Document the specific genetic cause in the medical record even if a more specific code is not available Consider requesting a code clarification from the provider if the genetic basis is identified Because G71.038 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

G71.038 ICD-10 Code: Other limb girdle muscular

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupG71.038Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

G71.038

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

Other limb girdle muscular dystrophy

A genetic muscle weakness disorder affecting the hip and shoulder muscles caused by a known genetic defect other than those specifically listed in the classification system.

Buddy Insight

Other limb girdle muscular dystrophy captures identified limb girdle muscular dystrophy subtypes that have a known genetic cause but do not have their own specific ICD-10-CM code.

CMS-HCC V28

Mapped

HCC 197

Muscular Dystrophy

RAF 0.0

CMS-HCC V24

Mapped

HCC 76

Muscular Dystrophy

RAF 0.358

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Mapped

HCC 76

Muscular Dystrophy

RAF 0.0

RXHCC

Not risk-adjusted for this model/period.

RAF 0

Code Trumping

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Compare selected patient codes to show trumped or trumps impact.

Code Book Path

Official

G71.0Muscular dystrophy

G71.03Limb girdle muscular dystrophies

G71.038Other limb girdle muscular dystrophy

Inclusion Terms

Official

LGMD R22 collagen 6-related
Other autosomal recessive limb girdle muscular dystrophy

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for G71.038 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

G71.033Limb girdle muscular dystrophy due to dysferlin dysfunction

G71.034Limb girdle muscular dystrophy due to sarcoglycan dysfunction

G71.035Limb girdle muscular dystrophy due to anoctamin-5 dysfunction

Includes

Official

ICD-10-CM does not list Includes notes for G71.038 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for G71.038 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for G71.038 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for G71.038 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for G71.038 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Genetic testing identifying the specific mutation causing the limb girdle dystrophy

Documentation of the specific genetic subtype in the medical record even without a dedicated code

Clinical presentation: distribution and severity of weakness

Functional status assessment

MEAT Support

HCC Buddy guidance

Genetic testing identifying the specific mutation causing the limb girdle dystrophy

Documentation of the specific genetic subtype in the medical record even without a dedicated code

Clinical presentation: distribution and severity of weakness

Functional status assessment

Audit Caution

HCC Buddy guidance

Using the unspecified limb girdle code (G71.039) instead of G71.038 when the genetic cause is known but lacks a specific code

Not documenting the specific genetic subtype in the record, which prevents auditors from verifying code accuracy

Using a specific subtype code (calpain-3, dysferlin, etc.) when the actual mutation is different

Failing to update coding when ICD-10-CM adds new specific codes for previously unclassified subtypes

Common Mistakes

HCC Buddy guidance

G71.039 — Limb girdle muscular dystrophy, unspecified is for when the genetic cause is unknown, not for known but unclassified subtypes

G71.032-G71.035 — Specific limb girdle subtypes should be used when those particular mutations are identified

G71.09 — Other specified muscular dystrophies is for non-limb girdle types of muscular dystrophy

G71.00 — Muscular dystrophy, unspecified is far too broad when limb girdle type is confirmed

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 G71.038 an HCC code?

Yes. G71.038 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 G71.038

For G71.038to 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 G71.038 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

G71.038 is the ICD-10-CM diagnosis code for other limb girdle muscular dystrophy. A genetic muscle weakness disorder affecting the hip and shoulder muscles caused by a known genetic defect other than those specifically listed in the classification system. G71.038 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, G71.038 maps to Muscular Dystrophy (HCC 197) with a community, non-dual, aged base RAF weight of 0.000. Under the older V24 model, G71.038 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.

Document the specific genetic cause in the medical record even if a more specific code is not available. Because G71.038 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 G71.038 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Document the specific genetic cause in the medical record even if a more specific code is not available
•Consider requesting a code clarification from the provider if the genetic basis is identified

Clinical Significance

Other limb girdle muscular dystrophy captures identified limb girdle muscular dystrophy subtypes that have a known genetic cause but do not have their own specific ICD-10-CM code. As new genetic subtypes continue to be identified, this code serves as a catch-all for genetically confirmed but unclassified types. Accurate coding reflects the progressive nature and care burden of these conditions.

Documentation Requirements

✓Genetic testing identifying the specific mutation causing the limb girdle dystrophy
✓Documentation of the specific genetic subtype in the medical record even without a dedicated code
✓Clinical presentation: distribution and severity of weakness
✓Functional status assessment
✓Exclusion of subtypes that have specific codes (calpain-3, dysferlin, sarcoglycan, anoctamin-5)
✓Provider's explicit diagnosis with the genetic or pathologic basis specified

Commonly Confused Codes

•G71.039: Limb girdle muscular dystrophy, unspecified is for when the genetic cause is unknown, not for known but unclassified subtypes
•G71.032-G71.035: Specific limb girdle subtypes should be used when those particular mutations are identified
•G71.09: Other specified muscular dystrophies is for non-limb girdle types of muscular dystrophy
•G71.00: Muscular dystrophy, unspecified is far too broad when limb girdle type is confirmed