ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 G11.10

Billable / Specific HCC v28: 72 CC

Early-onset cerebellar ataxia, unspecified

G11
Block
0
Synonyms
531
LCDs
17
Payer Policies
74
Linked CPTs

About ICD-10-CM G11.10

ICD-10-CM code G11.10 represents Early-onset cerebellar ataxia, unspecified. This is a billable/specific code in the Nervous System chapter (block G11). The 2026 edition of ICD-10-CM G11.10 became effective on October 1, 2025.

Coding Tips for G11.10

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

HCC capture: document with MEAT each year

G11.10 is a CMS-HCC v28 risk-adjustment code (category 72). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.

Inpatient DRG impact: CC

G11.10 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 72
ESRD-HCC
Category 72
RxHCC (Part D)
Category 72

Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.

Inpatient DRG Impact, CC

codes Early-onset cerebellar ataxia, unspecified. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for G11.10

Local Coverage Determinations (LCDs) from CMS MACs that list G11.10 as a covered diagnosis.

531 LCDs

Showing top 10 of 531 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95909 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95887 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95912 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95999 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95910 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95870 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95860 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95913 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95869 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT G0255 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing G11.10.

17 policies

1 Cigna

Electrodiagnostic Testing (EMG/NCV) - (CPG129)
Policy ID: CPG129_EMG_NCV_SSEP

5 Medicare

Billing and Coding: Home Health Occupational Therapy
Policy ID: ART-53057
Billing and Coding: Home Health Physical Therapy
Policy ID: ART-53058
Billing and Coding: Outpatient Occupational Therapy
Policy ID: ART-53064
Billing and Coding: Outpatient Physical Therapy
Policy ID: ART-53065
Billing and Coding: Cardiac Catheterization and Coronary Angiography
Policy ID: ART-56500

1 Aetna

Genetic Testing
Policy ID: CPB-0140

CPT Codes Commonly Billed with G11.10

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

74 linkages
  • 29405 CMS LCD: Billing and Coding: Outpatient Physical Therapy CMS LCD
  • 95992 CMS LCD: Billing and Coding: Outpatient Physical Therapy CMS LCD
  • 29280 CMS LCD: Billing and Coding: Outpatient Physical Therapy CMS LCD
  • 97010 CMS LCD: Billing and Coding: Outpatient Physical Therapy CMS LCD
  • 29515 CMS LCD: Billing and Coding: Outpatient Physical Therapy CMS LCD
  • 97550 CMS LCD: Billing and Coding: Outpatient Physical Therapy CMS LCD
  • 97116 CMS LCD: Billing and Coding: Outpatient Physical Therapy CMS LCD
  • 97546 CMS LCD: Billing and Coding: Outpatient Physical Therapy CMS LCD
  • 29445 CMS LCD: Billing and Coding: Outpatient Physical Therapy CMS LCD
  • 29075 CMS LCD: Billing and Coding: Outpatient Physical Therapy CMS LCD

ICD-10 G11.10, Billing FAQ

Is ICD-10 code G11.10 billable? +

Yes, G11.10 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Does G11.10 affect Medicare Advantage HCC risk adjustment? +

Yes. G11.10 maps to CMS-HCC v28 category 72. Capture this diagnosis annually for accurate Medicare Advantage risk score.

Is G11.10 a CC or MCC for inpatient DRG? +

Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.

What CPT codes are commonly billed with G11.10? +

Procedures frequently paired with G11.10 include: 29405, 95992, 29280, 97010, 29515.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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