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

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

Coding at a Glance

Tabular directives
5 Excludes1
Risk adjustment
CMS-HCC V28: 1 category

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 545 — CONNECTIVE TISSUE DISORDERS WITH MCC (MDC 08)
  • MS-DRG 546 — CONNECTIVE TISSUE DISORDERS WITH CC (MDC 08)
  • MS-DRG 547 — CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC (MDC 08)

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 93 — Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders (supersedes HCC 94)

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

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for G72.41 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on G72.41 itself; “inherited from” names the category or block whose note applies here.

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Source: inherited from G72

Coder workflow for G72.41

MedCoder structured workflow — derived from this code’s own official record

Before you code G72.41

  1. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with G72.41. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support a condition named in G72.41’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewQ74.3, M33, M62.2, M60, M33.2

Consider G72.41. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).

Official instructions as workflow

  • Excludes1 — check before selecting G72.41(5 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with G72.41: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareQ74.3, M33, M62.2, M60, M33.2

    See the official tabular notes · Guidelines I.A.12.a

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition G72.41 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewQ74.3, M33, M62.2, M60, M33.2

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse G72.41 with…

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

The codes most likely to be picked instead of G72.41 — 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.

  • Q74.3— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of arthrogryposis multiplex congenita moves the case to Q74.3; the two are not reported together unless documented as unrelated.

    Full comparison: G72.41 vs Q74.3 →

  • M33— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of dermatopolymyositis moves the case to M33; the two are not reported together unless documented as unrelated.

    Full comparison: G72.41 vs M33 →

  • M62.2— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of ischemic infarction of muscle moves the case to M62.2; the two are not reported together unless documented as unrelated.

    Full comparison: G72.41 vs M62.2 →

  • M60— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of myositis moves the case to M60; the two are not reported together unless documented as unrelated.

    Full comparison: G72.41 vs M60 →

  • M33.2— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of polymyositis moves the case to M33.2; the two are not reported together unless documented as unrelated.

    Full comparison: G72.41 vs M33.2 →

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.

Code Overview

Inclusion body myositis [IBM] is a billable ICD-10-CM diagnosis code (G72.41).

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

Indexed Clinical Terms (1)

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.

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

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 structured relationships — computed from published CMS and AHRQ datasets

Other codes that name G72.41 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 6 Excludes2 notes: M60 — Myositis, M60 — Myositis (via G72.-), M60-M63 — Disorders of muscles (M60-M63) (via G72.-), M61 — Calcification and ossification of muscle (via G72.-), M62 — Other disorders of muscle (via G72.-), M63 — Disorders of muscle in diseases classified elsewhere (via G72.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Referenced by 1 Code First instruction: M62.84 — Sarcopenia (via G72.-).

Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 3 MS-DRGs: DRG 545 (MDC 08), DRG 546 (MDC 08), DRG 547 (MDC 08).

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

Clinical classification (AHRQ CCSR):NVS018 — Myopathies (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 CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders) for risk-adjusted payment.

D86.86 — Sarcoid arthropathy, D86.87 — Sarcoid myositis, I77.82 — Antineutrophilic cytoplasmic antibody [ANCA] vasculitis, L40.50 — Arthropathic psoriasis, unspecified, L40.51 — Distal interphalangeal psoriatic arthropathy, L40.52 — Psoriatic arthritis mutilans, L40.53 — Psoriatic spondylitis, L40.54 — Psoriatic juvenile arthropathy, L40.59 — Other psoriatic arthropathy, M05.00 — Felty's syndrome, unspecified site, M05.011 — Felty's syndrome, right shoulder, M05.012 — Felty's syndrome, left shoulder, M05.019 — Felty's syndrome, unspecified shoulder, M05.021 — Felty's syndrome, right elbow, M05.022 — Felty's syndrome, left elbow, M05.029 — Felty's syndrome, unspecified elbow, M05.031 — Felty's syndrome, right wrist, M05.032 — Felty's syndrome, left wrist, M05.039 — Felty's syndrome, unspecified wrist, M05.041 — Felty's syndrome, right hand, +487 more

Related risk categories

These categories interact through CMS's HCC hierarchy — one can suppress the other's risk-adjustment weight when both are present on a claim.

Systemic Lupus Erythematosus and Other Specified Systemic Connective Tissue Disorders

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Myopathies).

G71.220 — X-linked myotubular myopathy, G71.228 — Other centronuclear myopathy, G71.29 — Other congenital myopathy, G71.3 — Mitochondrial myopathy, not elsewhere classified, G71.8 — Other primary disorders of muscles, G71.9 — Primary disorder of muscle, unspecified, G72.0 — Drug-induced myopathy, G72.1 — Alcoholic myopathy, G72.2 — Myopathy due to other toxic agents, G72.3 — Periodic paralysis, G72.49 — Other inflammatory and immune myopathies, not elsewhere classified, G72.81 — Critical illness myopathy, G72.89 — Other specified myopathies, G72.9 — Myopathy, unspecified, G73.1 — Lambert-Eaton syndrome in neoplastic disease, G73.3 — Myasthenic syndromes in other diseases classified elsewhere, G73.7 — Myopathy in diseases classified elsewhere, M05.40 — Rheumatoid myopathy with rheumatoid arthritis of unspecified site, M05.411 — Rheumatoid myopathy with rheumatoid arthritis of right shoulder, M05.412 — Rheumatoid myopathy with rheumatoid arthritis of left shoulder, +53 more

Same Index main term, other category

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

A48.0 — Gas gangrene (clostridial), A51.49 — Other secondary syphilitic conditions (in, syphilis, secondary), A52.78 — Syphilis of other musculoskeletal tissue (in, syphilis, late), B33.0 — Epidemic myalgia (epidemic), B49 — Unspecified mycosis (mycotic), B58.82 — Toxoplasma myositis (in, toxoplasmosis), B65.9 — Schistosomiasis, unspecified (in, bilharziasis), B69.81 — Myositis in cysticercosis (in, cysticercosis), B75 — Trichinellosis (in, trichinellosis), D86.87 — Sarcoid myositis (in, sarcoidosis), H05.12 — Orbital myositis (orbital, chronic), M60.000 — Infective myositis, unspecified right arm (infective, arm, right), M60.001 — Infective myositis, unspecified left arm (infective, arm, left), M60.002 — Infective myositis, unspecified arm (infective, arm), M60.003 — Infective myositis, unspecified right leg (infective, leg, right), M60.004 — Infective myositis, unspecified left leg (infective, leg, left), M60.005 — Infective myositis, unspecified leg (infective, leg), M60.009 — Infective myositis, unspecified site (infective), M60.01 — Infective myositis, shoulder (infective, upper limb, shoulder region), M60.02 — Infective myositis, upper arm (infective, upper limb, upper arm), +71 more

Contextual Map

Every relationship of G72.41 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.

Run G72.41 with these 6 related codes in Claim Check

Hierarchy

Referenced by Excludes2 notes

Referenced by Code First instructions

  • M62.84 — Sarcopenia[Code First](via G72.-): “other and unspecified myopathies (G72.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

  • HCC 93 — Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders [CMS-HCC]: “Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders — supersedes HCC 94 (Systemic Lupus Erythematosus and Other Specified Systemic Connective Tissue Disorders)”— CMS-HCC V28 · 2026

MS-DRG Grouper

MDC crossing

  • MDC 08 — Diseases and Disorders of the Musculoskeletal System and Connective Tissue[MDC crossing]: “Diseases and Disorders of the Musculoskeletal System and Connective Tissue — 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. 18,439 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027

Index entries

  • Myositis, inclusion body [IBM][Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027

Nearest codes (11)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

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 structured 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 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.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

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. "G72.41 — Inclusion body myositis [IBM]." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/g72.41-inclusion-body-myositis-ibm

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Inclusion body myositis [IBM]

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to G72.41 in its code family, with their registry titles.

View all codes in the G72 family