2027 ICD-10-CM Diagnosis Code G72.81Critical illness myopathy
ICD-10-CM Codes›G00–G99›G70-G73›G72
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Chronic Condition
G72.81 is a billable ICD-10-CM diagnosis code for critical illness 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 40 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Myopathies.
G72.81 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
Code Classification
Medicare Risk Adjustment (HCC)Billing
G72.81 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.
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.
- Critical illness myopathy
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to G72.81: 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.
Applicable To
Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.
- Acute necrotizing myopathy
- Acute quadriplegic myopathy
- Intensive care (ICU) myopathy
- Myopathy of critical illness
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
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.
- 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)
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name G72.81, its category, or a range that includes it.
Excludes2 1
These codes carry an Excludes2 note naming G72.81: its condition is not part of those codes, and both may be reported when the patient has both.
- Block M60-M63 Disorders of muscles
Code First 1
These codes say to code first a condition named in the note, and G72.81 is one of the conditions named.
Use Additional Code 2
These codes say to use an additional code from the note, and G72.81 is one of the codes named.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
necrotizing G72.81
quadriplegic G72.81
critical illness G72.81
intensive care (ICU) G72.81
of critical illness G72.81
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Critical Illness Myopathy
acute muscle weakness and paralysis that develops in critically ill patients who have been treated with multiple drugs during their intensive care unit stay. it is associated with delayed weaning from mechanical ventilation and prolonged rehabilitation.
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 G72.81 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About G72.81Overview
What is the ICD-10 code for critical illness myopathy?
The ICD-10-CM code for critical illness myopathy is G72.81 (sometimes written as G7281). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is G72.81 (Other specified myopathies) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report critical illness myopathy on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does G72.81 group to?
When critical illness 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 G72.81 a CC or MCC?
CMS lists G72.81 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 40 closely related codes in its exclusion list.
Can G72.81 be reported with Q74.3?
Not as a rule. The Excludes1 note at G72, which applies to G72.81, 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 G72.81 risk-adjust for Medicare Advantage payment?
Not for Medicare Advantage: G72.81 maps to no category in the CMS-HCC V28 model. It still risk-adjusts in the ESRD (V21) category 75 (Polyneuropathy).
