ICD-10 G71.0342
Billable / Specific HCC v28: 76Limb girdle muscular dystrophy due to beta sarcoglycan dysfunction
About ICD-10-CM G71.0342
ICD-10-CM code G71.0342 represents Limb girdle muscular dystrophy due to beta sarcoglycan dysfunction. This is a billable/specific code in the Nervous System chapter (block G71). The 2026 edition of ICD-10-CM G71.0342 became effective on October 1, 2025.
Coding Tips for G71.0342
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
G71.0342 is a CMS-HCC v28 risk-adjustment code (category 76). 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.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under G71.0342. Per CMS ICD-10-CM Tabular 2026.
- Beta sarcoglycanopathy
- Limb girdle muscular dystrophy due to beta-sarcoglycan deficiency
- Limb girdle muscular dystrophy type 2E
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Medicare LCD Coverage for G71.0342
Local Coverage Determinations (LCDs) from CMS MACs that list G71.0342 as a covered diagnosis.
Showing top 10 of 561 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing G71.0342.
3 Cigna
5 Medicare
CPT Codes Commonly Billed with G71.0342
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 G71.0342
Other codes in section G70-G73 (Diseases of myoneural junction and muscle).
ICD-10 G71.0342, Billing FAQ
Is ICD-10 code G71.0342 billable? +
Yes, G71.0342 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 G71.0342? +
ICD-10 G71.0342 includes: Beta sarcoglycanopathy; Limb girdle muscular dystrophy due to beta-sarcoglycan deficiency; Limb girdle muscular dystrophy type 2E.
Does G71.0342 affect Medicare Advantage HCC risk adjustment? +
Yes. G71.0342 maps to CMS-HCC v28 category 76. Capture this diagnosis annually for accurate Medicare Advantage risk score.
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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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