G71.11: Myotonic muscular dystrophy
G71.11, myotonic muscular dystrophy, is listed as a covered diagnosis in 13 Medicare billing and coding articles that apply to 19 HCPCS Level II codes, including A7020 (Interface for cough stimulating device, includes all…), E0483 (High frequency chest wall oscillation system, with full…), A7025 (High frequency chest wall oscillation system vest…). 4 of these codes have a 2026 DMEPOS fee schedule amount; A7020 pays $19.87 to $23.81 (NU) depending on the state. The articles come from 5 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with G71.11 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| A7020 | Interface for cough stimulating device, includes all components, replacement only | Carrier judgment | $19.87–$23.81 (NU) | 1 |
| E0483 | High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each | Carrier judgment | $1,515.12–$1,818.13 (RR) | 1 |
| A7025 | High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each | Carrier judgment | $61.99–$74.42 (RR) | 1 |
| A7026 | High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each | Carrier judgment | $40.96–$49.15 (NU) | 1 |
| G0278 | Iliac and/or femoral artery angiography, non-selective, bilateral or ipsilateral to catheter insertion, performed at the same time as cardiac catheterization and/or coronary angiography, includes positioning or placement of the catheter in the distal aorta or ipsilateral femoral or iliac artery, injection of dye, production of permanent images, and radiologic supervision and interpretation (list separately in addition to primary procedure) | Carrier judgment | — | 2 |
| G0269 | Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure (e.g., angioseal plug, vascular plug) | Special coverage instructions apply | — | 2 |
| G0153 | Services performed by a qualified speech-language pathologist in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0161 | Services performed by a qualified speech-language pathologist, in the home health setting, in the establishment or delivery of a safe and effective speech-language pathology maintenance program, each 15 minutes | Carrier judgment | — | 1 |
| G0238 | Therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring) | Carrier judgment | — | 1 |
| G0237 | Therapeutic procedures to increase strength or endurance of respiratory muscles, face to face, one on one, each 15 minutes (includes monitoring) | Carrier judgment | — | 1 |
| G0239 | Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring) | Carrier judgment | — | 1 |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | Carrier judgment | — | 2 |
| G0152 | Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0158 | Services performed by a qualified occupational therapist assistant in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0160 | Services performed by a qualified occupational therapist, in the home health setting, in the establishment or delivery of a safe and effective occupational therapy maintenance program, each 15 minutes | Carrier judgment | — | 1 |
| G2169 | Services performed by an occupational therapist assistant in the home health setting in the delivery of a safe and effective occupational therapy maintenance program, each 15 minutes | Carrier judgment | — | 1 |
| G0281 | Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care | Carrier judgment | — | 1 |
| G0329 | Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care | Carrier judgment | — | 1 |
| G0255 | Current perception threshold/sensory nerve conduction test, (snct) per limb, any nerve | Non-covered by Medicare | Not covered | 5 |
Medicare policy articles listing G71.11
- A52510: Mechanical In-exsufflation Devices - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC); 1 Level II codes). LCD with the same title: L33795
- A52494: High Frequency Chest Wall Oscillation Devices - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC); 3 Level II codes). LCD with the same title: L33785
- A53052: Billing and Coding: Home Health Speech-Language Pathology (Palmetto GBA (HHH MAC); 2 Level II codes). LCD with the same title: L34563
- A56500: Billing and Coding: Cardiac Catheterization and Coronary Angiography (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L33557, L33959
- A52850: Billing and Coding: Cardiac Catheterization and Coronary Angiography (Wellpoint Federal (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L33557, L33959
- A57224: Billing and Coding: Respiratory Care (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L34149
- A57307: Billing and Coding: Nerve Conduction Studies and Electromyography (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
- A57478: Billing and Coding: Nerve Conduction Studies and Electromyography (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
- A54969: Billing and Coding: Nerve Conduction Studies and Electromyography (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
- A57668: Billing and Coding: Nerve Conduction Studies and Electromyography (Wellpoint Federal (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
- A56619: Billing and Coding: Nerve Conduction Studies and Electromyography (Palmetto GBA (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
- A53057: Billing and Coding: Home Health Occupational Therapy (Palmetto GBA (HHH MAC); 5 Level II codes). LCD with the same title: L34560
- A53064: Billing and Coding: Outpatient Occupational Therapy (Palmetto GBA (MAC - Part A); 3 Level II codes). LCD with the same title: L34427
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other G71 diagnoses (Primary disorders of muscles)
- G71.12 — Myotonia congenita
- G71.13 — Myotonic chondrodystrophy
- G71.14 — Drug induced myotonia
- G71.19 — Other specified myotonic disorders
- G71.00 — Muscular dystrophy, unspecified
- G71.01 — Duchenne or Becker muscular dystrophy
- G71.02 — Facioscapulohumeral muscular dystrophy
- G71.031 — Autosomal dominant limb girdle muscular dystrophy
- G71.032 — Autosomal recessive limb girdle muscular dystrophy due to calpain-3…
- G71.033 — Limb girdle muscular dystrophy due to dysferlin dysfunction
- G71.0340 — Limb girdle muscular dystrophy due to sarcoglycan dysfunction…
- G71.0341 — Limb girdle muscular dystrophy due to alpha sarcoglycan dysfunction
- G71.0342 — Limb girdle muscular dystrophy due to beta sarcoglycan dysfunction
- G71.0349 — Limb girdle muscular dystrophy due to other sarcoglycan dysfunction
- G71.035 — Limb girdle muscular dystrophy due to anoctamin-5 dysfunction
- G71.036 — Limb girdle muscular dystrophy due to fukutin related protein…
- G71.038 — Other limb girdle muscular dystrophy
- G71.039 — Limb girdle muscular dystrophy, unspecified
- G71.09 — Other specified muscular dystrophies
- G71.20 — Congenital myopathy, unspecified
- G71.21 — Nemaline myopathy
- 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
Frequently asked questions
Does Medicare cover G71.11 (Myotonic muscular dystrophy)?
Medicare covers items and services, not diagnoses. 13 Medicare billing and coding articles list G71.11 as a covered diagnosis for 19 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 G71.11?
The Level II codes from the policies most specific to this diagnosis are A7020 (Interface for cough stimulating device, includes all…, 1 article); E0483 (High frequency chest wall oscillation system, with full…, 1 article); A7025 (High frequency chest wall oscillation system vest…, 1 article); A7026 (High frequency chest wall oscillation system hose…, 1 article); G0278 (Iliac and/or femoral artery angiography, non-selective…, 2 articles). Code choice depends on the item supplied; check each code's descriptor.
What does Medicare pay for equipment billed with G71.11?
Under the 2026 DMEPOS fee schedule (non-rural state fees): A7020 $19.87 to $23.81 (NU); E0483 $1,515.12 to $1,818.13 (RR); A7025 $61.99 to $74.42 (RR); A7026 $40.96 to $49.15 (NU). Medicare pays 80% of the allowed amount after the Part B deductible.
Which Medicare policy articles list G71.11?
A52510 (Mechanical In-exsufflation Devices - Policy Article); A52494 (High Frequency Chest Wall Oscillation Devices - Policy Article); A53052 (Billing and Coding: Home Health Speech-Language Pathology), and 10 more articles.
What is ICD-10-CM code G71.11?
G71.11 is the ICD-10-CM code for myotonic muscular dystrophy, in category G71 (Primary disorders of muscles), chapter 6: Diseases of the nervous system.
Next steps
- Run a reimbursement report for a device billed under A7020
- Watch A7020 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A7020
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 6: Diseases of the nervous system · All diagnoses · HCPCS lookup