2026 ICD-10-CM Diagnosis Code G72.41Inclusion body myositis [IBM]

ICD-10-CM Codes›G00–G99›G70-G73›G72

ICD-10-CM G72.41
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

G72.41 is a billable ICD-10-CM diagnosis code for inclusion body myositis [IBM]. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 545 through 547. Coders also document this condition as hereditary inclusion body myopathy, joint contracture, ophthalmoplegia syndrome. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Myopathies.

For Medicare Advantage risk adjustment, G72.41 maps to CMS-HCC Category 93 (Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders) under the V28 model, adding a risk factor of about 0.617 for a community, non-dual, aged beneficiary in payment year 2026.

Code Identity

ICD-10-CM Code
G72.41
Billable Status
Yes — Valid for Submission
Code Describes
Inclusion body myositis [IBM]
Short Description
Inclusion body myositis [IBM]
Same as the full description in the CMS dataset.
Parent Code
G72.4
Inflammatory and immune myopathies, not elsewhere classified

Code Classification

ChapterG00–G99Diseases of the nervous system
SectionG70-G73Diseases of myoneural junction and muscle
CategoryG72Other and unspecified myopathies
This CodeG72.41Inclusion body myositis [IBM]

Medicare Risk Adjustment (HCC)Billing

G72.41 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2026.

CMS-HCC V28 Category (Payment Model)
HCC 93— Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders
Payment HCC · PY 2026 one of 508 ICD-10-CM codes in this category
Risk Adjustment Factor (RAF) Weight
+0.617
community, non-dual, aged · ranges 0.288–0.617 across segments
Hierarchy
Supersedes HCC 94
less severe related categories are not paid alongside HCC 93
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
G72.41 does not risk-adjust in the RxHCC prescription drug model

Source: CMS Payment Year 2026 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.

  • Hereditary inclusion body myopathy, joint contracture, ophthalmoplegia syndrome
  • Inclusion body myositis
  • Myopathy with cytoplasmic inclusions
  • Sporadic inclusion body myositis

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

Clinical InformationClinical

  • Inclusion Body Myositis

    an acquired or hereditary chronic inflammatory disorder of the muscles characterized by the morphologic finding of vacuoles and filamentous inclusions in the muscle tissues.

Patient EducationClinical

Muscle Disorders

Your muscles help you move and help your body work. Different types of muscles have different jobs. There are many problems that can affect muscles. Muscle disorders can cause weakness, pain or even paralysis.

Read the full article at MedlinePlus

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

Convert G72.41 to ICD-9-CMHistory

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

ICD-9-CM
359.71 Inclusion body myositis
Exact Match The mapping is direct, with no qualifiers.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About G72.41Overview

What is the ICD-10 code for inclusion body myositis [IBM]?

The ICD-10-CM code for inclusion body myositis [IBM] is G72.41 (sometimes written as G7241). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

Is G72.41 (Inflammatory and immune myopathies, not elsewhere classified) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report inclusion body myositis [IBM] on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does G72.41 group to?

When inclusion body myositis [IBM] is the principal diagnosis on an inpatient stay, it groups to MS-DRG 545, 546, 547, with relative weights from 0.8362 to 2.4817 depending on complications. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of G72.41?

Under the General Equivalence Mappings, inclusion body myositis [IBM] converts to ICD-9-CM 359.71 (inclusion body myositis). The mapping is a direct match.

What HCC is G72.41?

G72.41 (inclusion body myositis [IBM]) maps to CMS-HCC Category 93 (Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders), commonly written as HCC 93, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2026. It also maps in the ESRD (V21) model. It does not map to any RxHCC in the Part D prescription drug model.

Does G72.41 risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, G72.41 adds a risk adjustment factor of about 0.617 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.288 to 0.617 depending on the payment segment). HCC 93 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 93 category page.