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

ICD-10 G72.49

Billable / Specific

Other inflammatory and immune myopathies, not elsewhere classified

G72
Block
1
Synonyms
656
LCDs
24
Payer Policies
3
Linked CPTs

About ICD-10-CM G72.49

ICD-10-CM code G72.49 represents Other inflammatory and immune myopathies, not elsewhere classified. This is a billable/specific code in the Nervous System chapter (block G72). The 2026 edition of ICD-10-CM G72.49 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under G72.49. Per CMS ICD-10-CM Tabular 2026.

  • Inflammatory myopathy NOS

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.

Medicare LCD Coverage for G72.49

Local Coverage Determinations (LCDs) from CMS MACs that list G72.49 as a covered diagnosis.

656 LCDs

Showing top 10 of 656 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94660 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94726 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94664 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94618 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94772 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94642 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT G0238 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94004 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94668 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94680 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing G72.49.

24 policies

5 Medicare

High Frequency Chest Wall Oscillation Devices - Policy Article
Policy ID: ART-52494
Mechanical In-exsufflation Devices - Policy Article
Policy ID: ART-52510
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

CPT Codes Commonly Billed with G72.49

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

3 linkages
  • J9190 CMS LCD: Billing and Coding: Chemotherapy Agents for Non-Oncologic Conditions CMS LCD
  • J9260 CMS LCD: Billing and Coding: Chemotherapy Agents for Non-Oncologic Conditions CMS LCD
  • J9215 CMS LCD: Billing and Coding: Chemotherapy Agents for Non-Oncologic Conditions CMS LCD

Convert G72.49 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
G72.49 35979 10000

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

ICD-10 G72.49, Billing FAQ

Is ICD-10 code G72.49 billable? +

Yes, G72.49 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 G72.49? +

ICD-10 G72.49 includes: Inflammatory myopathy NOS.

What CPT codes are commonly billed with G72.49? +

Procedures frequently paired with G72.49 include: J9190, J9260, J9215.

What ICD-9 codes does G72.49 map to? +

Per CMS GEMs, G72.49 maps to ICD-9 codes: 35979. 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 July 16, 2026.

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