2027 ICD-10-CM Diagnosis Code G72.1Alcoholic myopathy

ICD-10-CM Codes›G00–G99›G70-G73›G72

ICD-10-CM G72.1
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

G72.1 is a billable ICD-10-CM diagnosis code for alcoholic myopathy. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 91 through 93. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 45 closely related codes. Coders also document this condition as acute alcoholic myopathy. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Myopathies.

G72.1 does not risk-adjust for Medicare Advantage under the CMS-HCC V28 model. It still risk-adjusts in the ESRD (V21) category 75 for payment year 2027.

Code Identity

ICD-10-CM Code
G72.1
Billable Status
Yes — Valid for Submission
Code Describes
Alcoholic myopathy
Short Description
Alcoholic myopathy
Same as the full description in the CMS dataset.
Parent Code
G72
Other and unspecified myopathies

Code Classification

ChapterG00–G99Diseases of the nervous system
SectionG70-G73Diseases of myoneural junction and muscle
CategoryG72Other and unspecified myopathies
This CodeG72.1Alcoholic myopathy

Medicare Risk Adjustment (HCC)Billing

G72.1 does not risk-adjust for Medicare Advantage under the CMS-HCC V28 model, but it maps to payment categories in the other CMS models shown below.

CMS-HCC V28 (Medicare Advantage Payment Model)
Not mapped
no payment category in the model that pays 100% of MA risk scores
Prior Model (CMS-HCC V24)
Not mapped under V24
this diagnosis newly risk-adjusts under the V28 model
Other CMS Models
ESRD (V21): HCC 75
ESRD V21 weights: 0.059 dialysis, 0.284–0.323 functioning graft
Part D (RxHCC)
Not mapped
G72.1 does not risk-adjust in the RxHCC prescription drug model

Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Acute alcoholic myopathy
  • Chronic alcoholic myopathy
  • Myopathy caused by alcohol
  • Myopathy due to chronic alcoholism

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to G72.1: its own notes plus those printed at G72 and Chapter 6. A note printed at a category, block or chapter applies to every code under it.

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From G72 Other and unspecified myopathies applies to 9 codes
  • arthrogryposis multiplex congenita (Q74.3)
  • dermatopolymyositis (M33.-)
  • ischemic infarction of muscle (M62.2-)
  • myositis (M60.-)
  • polymyositis (M33.2.-)

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From Chapter 6 (G00-G99) Diseases of the nervous system applies to 700 codes
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

Use Additional Code

Add a second code, after this one, to fully describe the condition.

  • code to identify alcoholism (F10.-)

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name G72.1, its category, or a range that includes it.

Excludes1 1

These codes carry an Excludes1 note naming G72.1: they are not reported together with it, unless the two conditions are unrelated.

  • M62 Other disorders of muscle
    alcoholic myopathy (G72.1)

Excludes2 1

These codes carry an Excludes2 note naming G72.1: its condition is not part of those codes, and both may be reported when the patient has both.

  • Block M60-M63 Disorders of muscles
    muscular dystrophies and myopathies (G71-G72) names G71-G72, which includes this code

Code First 1

These codes say to code first a condition named in the note, and G72.1 is one of the conditions named.

  • M62.84 Sarcopenia
    other and unspecified myopathies (G72.-) names G72.-, which includes this code

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR NVS018
Myopathies
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Alcohol Use Disorder (AUD)

For most adults, moderate alcohol use is probably not harmful. Your risk of developing an alcohol use disorder (AUD) depends on how much, how often, and how quickly you drink alcohol. Alcohol misuse means that drinking causes distress and harm. Over time alcohol misuse can increase your risk of AUD.

The full article covers:

  • What is alcohol use disorder (AUD)?
  • What is binge drinking?
  • What are the dangers of too much alcohol?
  • How do I know if I have an alcohol use disorder (AUD)?
  • What should I do if I think that I might have an alcohol use disorder (AUD)?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert G72.1 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
359.4 Toxic myopathy
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About G72.1Overview

What is the ICD-10 code for alcoholic myopathy?

The ICD-10-CM code for alcoholic myopathy is G72.1 (sometimes written as G721). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is G72.1 (Other and unspecified myopathies) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report alcoholic myopathy on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does G72.1 group to?

When alcoholic myopathy is the principal diagnosis on an inpatient stay, it groups to MS-DRG 91, 92, 93, with relative weights from 0.7783 to 1.7050 depending on complications. Higher weights mean higher Medicare reimbursement.

Is G72.1 a CC or MCC?

CMS lists G72.1 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 45 closely related codes in its exclusion list.

Can G72.1 be reported with Q74.3?

Not as a rule. The Excludes1 note at G72, which applies to G72.1, lists "arthrogryposis multiplex congenita (Q74.3)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).

Does G72.1 risk-adjust for Medicare Advantage payment?

Not for Medicare Advantage: G72.1 maps to no category in the CMS-HCC V28 model. It still risk-adjusts in the ESRD (V21) category 75 (Polyneuropathy).