ICD-10 G12
Non-Billable HeaderSpinal muscular atrophy and related syndromes
About ICD-10-CM G12
ICD-10-CM code G12 represents Spinal muscular atrophy and related syndromes. This is a non-billable header code in the Nervous System chapter (block G12). The 2026 edition of ICD-10-CM G12 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Medicare LCD Coverage for G12
Local Coverage Determinations (LCDs) from CMS MACs that list G12 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing G12.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but G12 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with G12
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To G12
Other codes in section G10-G14 (Systemic atrophies primarily affecting the central nervous system).
ICD-10 G12, Billing FAQ
Is ICD-10 code G12 billable? +
No, G12 is a non-billable header code. Use a more specific child code from block G12 when submitting claims.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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