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G12.25 ICD-10-CM Code: Progressive spinal muscle atrophy

Compare with another code for G12.25Check this code on a claim

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Risk adjustment
CMS-HCC V28: 1 category · CMS-HCC V22 category 73 · RxHCC V08 category 154

Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too; the Instructions section marks which is which.

The tabular list publishes no instructional note for this code itself.

Where it sits Source: CMS/NCHS

Under:Chapter 6: Diseases of the Nervous SystemG10-G14 Systemic atrophies primarily affecting the central nervous systemG12 Spinal muscular atrophy and related syndromesG12.2 Motor neuron disease

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Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 056 — DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC (MDC 01)
  • MS-DRG 057 — DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC (MDC 01)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 190 — Amyotrophic Lateral Sclerosis and Other Motor Neuron Disease, Spinal Muscular Atrophy

Other models: CMS-HCC V22 HCC 73 · RxHCC V08 HCC 154

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Don’t confuse G12.25 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of G12.25 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • G12.20— Specificity relationship (Review)

    Overlapping diagnoses in the same category.

    Overlapping codes in the same category — the documentation decides which is the more specific fit.

    What moves you there: A record that documents no more than “Motor neuron disease, unspecified” takes G12.20; specificity in the record moves it back here.

    Full comparison: G12.25 vs G12.20 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Progressive spinal muscle atrophy is a billable ICD-10-CM diagnosis code (G12.25).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Verify Before Coding

  • CC as a secondary diagnosis (FY2027). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder-derived relationships — computed from published CMS and AHRQ datasets

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 111 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 2 MS-DRGs: DRG 056 (MDC 01), DRG 057 (MDC 01).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):NVS006 — Other nervous system disorders (often hereditary or degenerative) (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical process (MS-DRG)

Acts as CC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.

G11.6 — Leukodystrophy with vanishing white matter disease, G11.8 — Other hereditary ataxias, G11.9 — Hereditary ataxia, unspecified, G12.0 — Infantile spinal muscular atrophy, type I [Werdnig-Hoffman], G12.1 — Other inherited spinal muscular atrophy, G12.20 — Motor neuron disease, unspecified, G12.21 — Amyotrophic lateral sclerosis, G12.22 — Progressive bulbar palsy, G12.23 — Primary lateral sclerosis, G12.24 — Familial motor neuron disease, G12.29 — Other motor neuron disease, G12.8 — Other spinal muscular atrophies and related syndromes, G12.9 — Spinal muscular atrophy, unspecified, G90.01 — Carotid sinus syncope, G90.09 — Other idiopathic peripheral autonomic neuropathy, G90.2 — Horner's syndrome, G90.4 — Autonomic dysreflexia, G90.50 — Complex regional pain syndrome I, unspecified, G90.511 — Complex regional pain syndrome I of right upper limb, G90.512 — Complex regional pain syndrome I of left upper limb, +90 more

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Amyotrophic Lateral Sclerosis and Other Motor Neuron Disease, Spinal Muscular Atrophy) for risk-adjusted payment.

G12.0 — Infantile spinal muscular atrophy, type I [Werdnig-Hoffman], G12.1 — Other inherited spinal muscular atrophy, G12.20 — Motor neuron disease, unspecified, G12.21 — Amyotrophic lateral sclerosis, G12.22 — Progressive bulbar palsy, G12.23 — Primary lateral sclerosis, G12.24 — Familial motor neuron disease, G12.29 — Other motor neuron disease, G12.8 — Other spinal muscular atrophies and related syndromes, G12.9 — Spinal muscular atrophy, unspecified

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Other nervous system disorders (often hereditary or degenerative)).

G11.6 — Leukodystrophy with vanishing white matter disease, G11.8 — Other hereditary ataxias, G11.9 — Hereditary ataxia, unspecified, G12.0 — Infantile spinal muscular atrophy, type I [Werdnig-Hoffman], G12.1 — Other inherited spinal muscular atrophy, G12.20 — Motor neuron disease, unspecified, G12.21 — Amyotrophic lateral sclerosis, G12.22 — Progressive bulbar palsy, G12.23 — Primary lateral sclerosis, G12.24 — Familial motor neuron disease, G12.29 — Other motor neuron disease, G12.8 — Other spinal muscular atrophies and related syndromes, G12.9 — Spinal muscular atrophy, unspecified, G21.0 — Malignant neuroleptic syndrome, G21.11 — Neuroleptic induced parkinsonism, G21.19 — Other drug induced secondary parkinsonism, G21.2 — Secondary parkinsonism due to other external agents, G21.3 — Postencephalitic parkinsonism, G21.4 — Vascular parkinsonism, G21.8 — Other secondary parkinsonism, +83 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Atrophy, atrophic”, “Paralysis, paralytic”; these codes share that main term but sit in a different category of the Tabular List.

E27.49 — Other adrenocortical insufficiency (adrenal), E31.0 — Autoimmune polyglandular failure (pluriglandular, autoimmune), E31.8 — Other polyglandular dysfunction (pluriglandular), E32.8 — Other diseases of thymus (thymus), E41 — Nutritional marasmus (infantile), E43 — Unspecified severe protein-calorie malnutrition (nutritional), F44.4 — Conversion disorder with motor symptom or deficit (hysterical), F44.89 — Other dissociative and conversion disorders (accommodation, hysterical), G11.4 — Hereditary spastic paraplegia (spastic, familial), G11.9 — Hereditary ataxia, unspecified (ataxic), G13.8 — Systemic atrophy primarily affecting central nervous system in other diseases classified elsewhere (systemic affecting central nervous system, in, specified disease NEC), G20.C — Parkinsonism, unspecified (agitans), G21.4 — Vascular parkinsonism (agitans, arteriosclerotic), G23.1 — Progressive supranuclear ophthalmoplegia [Steele-Richardson-Olszewski] (supranuclear), G23.8 — Other specified degenerative diseases of basal ganglia (Déjérine-Thomas), G31.01 — Pick's disease (brain, frontotemporal circumscribed), G31.09 — Other frontotemporal neurocognitive disorder (sclerosis, lobar), G31.1 — Senile degeneration of brain, not elsewhere classified (brain, senile NEC), G31.9 — Degenerative disease of nervous system, unspecified (brain), G46.3 — Brain stem stroke syndrome (Gubler), +207 more

Contextual Map

Every relationship of G12.25 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Hierarchy

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

  • HCC 190 — Amyotrophic Lateral Sclerosis and Other Motor Neuron Disease, Spinal Muscular Atrophy [CMS-HCC]— CMS-HCC V28 · 2026

MS-DRG Grouper

MDC crossing

  • MDC 01 — Diseases and Disorders of the Nervous System[MDC crossing]: “Diseases and Disorders of the Nervous System — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 8,919 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027

Index entries

  • Amyotrophia, amyotrophy, amyotrophic, spinal progressive[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Atrophy, atrophic (of), muscle, muscular (diffuse) (general) (idiopathic) (primary), progressive (bulbar), spinal[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Atrophy, atrophic (of), muscle, muscular (diffuse) (general) (idiopathic) (primary), spinal, progressive[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Atrophy, atrophic (of), spinal (acute) (cord), paralysis, meaning progressive muscular atrophy[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Paralysis, paralytic (complete) (incomplete), muscle, muscular NEC, progressive, spinal[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Paralysis, paralytic (complete) (incomplete), muscle, muscular NEC, spinal progressive[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Paralysis, paralytic (complete) (incomplete), spinal (cord), progressive, muscle[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027

Nearest codes (12)

Change history

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Indexed Clinical Terms (7)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 Release, file and checksum · Publisher’s page
Risk adjustment Official source data
2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder-derived relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder editorial explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "G12.25 — Progressive spinal muscle atrophy." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/g12.25-progressive-spinal-muscle-atrophy

Change history

  • FY2018 — October 1, 2017
    Added to the code set
    Progressive spinal muscle atrophy
    FY2018 changes

Nearest Codes in This Family

Official ICD-10-CM classifications closest to G12.25 in its code family, with their registry titles.

View all codes in the G12 family