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G71.039 ICD-10-CM Code: Limb girdle muscular dystrophy, unspecified

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

G71.039

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

Limb girdle muscular dystrophy, unspecified

A genetic muscle weakness disorder affecting the hip and shoulder muscles where the specific genetic cause has not been identified or is not documented.

Buddy the Bee presenting code insight

Buddy Insight

Limb girdle muscular dystrophy, unspecified indicates proximal muscle weakness in a limb girdle pattern where the specific genetic subtype has not been determined.

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
G71.039Limb girdle muscular dystrophy, unspecified

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for G71.039 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for G71.039 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 G71.039 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for G71.039 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for G71.039 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for G71.039 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for G71.039 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Clinical features consistent with limb girdle muscular dystrophy: proximal weakness, elevated creatine kinase
Documentation of diagnostic workup status: genetic testing pending, refused, or unavailable
Exclusion of other causes of proximal weakness
Functional status and disease progression

MEAT Support

HCC Buddy guidance
Clinical features consistent with limb girdle muscular dystrophy: proximal weakness, elevated creatine kinase
Documentation of diagnostic workup status: genetic testing pending, refused, or unavailable
Exclusion of other causes of proximal weakness
Functional status and disease progression

Audit Caution

HCC Buddy guidance
Remaining with this unspecified code after genetic testing has provided a specific subtype
Not prompting the provider to pursue genetic testing when limb girdle muscular dystrophy is suspected
Confusing limb girdle muscular dystrophy with acquired inflammatory myopathy (polymyositis), which is treatable
Using the broader unspecified muscular dystrophy code when the limb girdle distribution is documented

Common Mistakes

HCC Buddy guidance
G71.00 — Muscular dystrophy, unspecified is even more broad; use G71.039 when the limb girdle pattern is identified
G71.031-G71.035 — Specific limb girdle subtypes should be used when genetic testing identifies the cause
G71.038 — Other limb girdle muscular dystrophy is for identified subtypes without dedicated codes
G72.9 — Myopathy, unspecified does not capture the genetic dystrophic nature

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 G71.039 an HCC code?

Yes. G71.039 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 G71.039

For G71.039to 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 G71.039 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

G71.039 is the ICD-10-CM diagnosis code for limb girdle muscular dystrophy, unspecified. A genetic muscle weakness disorder affecting the hip and shoulder muscles where the specific genetic cause has not been identified or is not documented. G71.039 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, G71.039 maps to Muscular Dystrophy (HCC 197) with a community, non-dual, aged base RAF weight of 0.000. Under the older V24 model, G71.039 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.

Use this code only when the genetic subtype cannot be determined despite clinical diagnosis. Because G71.039 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 G71.039 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Use this code only when the genetic subtype cannot be determined despite clinical diagnosis
  • Encourage genetic testing and documentation to allow for more specific coding in the future

Clinical Significance

Limb girdle muscular dystrophy, unspecified indicates proximal muscle weakness in a limb girdle pattern where the specific genetic subtype has not been determined. This code should be a placeholder pending genetic workup results. It still carries HCC value and reflects a patient with significant progressive neuromuscular disease requiring ongoing management.

Documentation Requirements

  • Clinical features consistent with limb girdle muscular dystrophy: proximal weakness, elevated creatine kinase
  • Documentation of diagnostic workup status: genetic testing pending, refused, or unavailable
  • Exclusion of other causes of proximal weakness
  • Functional status and disease progression
  • Referral to genetics or neuromuscular specialist if not already done
  • Provider's explicit diagnosis of limb girdle muscular dystrophy

Commonly Confused Codes

  • G71.00: Muscular dystrophy, unspecified is even more broad; use G71.039 when the limb girdle pattern is identified
  • G71.031-G71.035: Specific limb girdle subtypes should be used when genetic testing identifies the cause
  • G71.038: Other limb girdle muscular dystrophy is for identified subtypes without dedicated codes
  • G72.9: Myopathy, unspecified does not capture the genetic dystrophic nature

Child Codes

Code Hierarchy

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