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

ICD-10 G60.1

Billable / Specific CC

Refsum's disease

G60
Block
1
Synonyms
630
LCDs
26
Payer Policies
11
Linked CPTs

About ICD-10-CM G60.1

ICD-10-CM code G60.1 represents Refsum's disease. This is a billable/specific code in the Nervous System chapter (block G60). The 2026 edition of ICD-10-CM G60.1 became effective on October 1, 2025.

Coding Tips for G60.1

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

Inpatient DRG impact: CC

G60.1 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.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under G60.1. Per CMS ICD-10-CM Tabular 2026.

  • Infantile Refsum disease

Medicare Advantage HCC Impact

ESRD-HCC
Category 75

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 Refsum's disease. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for G60.1

Local Coverage Determinations (LCDs) from CMS MACs that list G60.1 as a covered diagnosis.

630 LCDs

Showing top 10 of 630 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 G60.1.

26 policies

1 Cigna

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

5 Medicare

Billing and Coding: Routine Foot Care
Policy ID: ART-52996
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

CPT Codes Commonly Billed with G60.1

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

11 linkages
  • 11006 CMS LCD: Billing and Coding: Wound and Ulcer Care CMS LCD
  • 97607 CMS LCD: Billing and Coding: Wound and Ulcer Care CMS LCD
  • 11008 CMS LCD: Billing and Coding: Wound and Ulcer Care CMS LCD
  • 11005 CMS LCD: Billing and Coding: Wound and Ulcer Care CMS LCD
  • 11012 CMS LCD: Billing and Coding: Wound and Ulcer Care CMS LCD
  • 11010 CMS LCD: Billing and Coding: Wound and Ulcer Care CMS LCD
  • 97608 CMS LCD: Billing and Coding: Wound and Ulcer Care CMS LCD
  • 97610 CMS LCD: Billing and Coding: Wound and Ulcer Care CMS LCD
  • 11011 CMS LCD: Billing and Coding: Wound and Ulcer Care CMS LCD
  • 29581 CMS LCD: Billing and Coding: Wound and Ulcer Care CMS LCD

Convert G60.1 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
G60.1 3563 00000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 G60.1, Billing FAQ

Is ICD-10 code G60.1 billable? +

Yes, G60.1 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to G60.1? +

ICD-10 G60.1 includes: Infantile Refsum disease.

Is G60.1 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 G60.1? +

Procedures frequently paired with G60.1 include: 11006, 97607, 11008, 11005, 11012.

What ICD-9 codes does G60.1 map to? +

Per CMS GEMs, G60.1 maps to ICD-9 codes: 3563. Useful for legacy data review and historical claim analysis.

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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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