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2025 ICD-10-CM code G72.49

Other inflammatory and immune myopathies, not elsewhere classified. This encompasses muscle disorders caused by inflammation or an abnormal immune response not captured by other codes.

Code G72.49 should be used when a more specific inflammatory or immune myopathy cannot be identified. It is important to rule out other specific myopathies (e.g., polymyositis, dermatomyositis, inclusion body myositis) before using this code.

Medical necessity for this code requires a demonstrable inflammatory or immune-mediated process affecting muscle function.Documentation should support the diagnosis and rule out other conditions.

In simple words: This code refers to muscle problems caused by inflammation or the body's immune system attacking its own muscles, that aren't covered by other, more specific codes.Symptoms can include muscle weakness, pain, tiredness, and shrinking of the muscles.

This code represents a group of muscle disorders characterized by inflammation or immune system dysfunction that are not specifically classified elsewhere in the ICD-10-CM.These myopathies can manifest with diverse symptoms, including muscle weakness, pain, fatigue, and atrophy.The underlying causes can vary, ranging from infections and injuries to autoimmune reactions.

Example 1: A patient presents with progressive muscle weakness, pain, and elevated creatine kinase levels.After extensive testing to rule out other causes, including infections, metabolic disorders, and other defined inflammatory myopathies like polymyositis or dermatomyositis, the diagnosis of an unspecified inflammatory myopathy is made, warranting the use of G72.49., A patient experiences muscle weakness and fatigue following a viral infection.Muscle biopsy reveals inflammatory changes, but the specific myopathy is not identifiable.The code G72.49 is applied due to the inflammatory nature and unspecified etiology., A patient with a history of autoimmune disease develops muscle symptoms.Investigations do not confirm a specific autoimmune myopathy, but the clinical picture strongly suggests an immune-mediated muscle disorder. In the absence of a more specific code, G72.49 is used.

Documentation should include detailed clinical findings (muscle weakness, pain, atrophy), laboratory results (creatine kinase, inflammatory markers), electromyography (EMG) findings, muscle biopsy results (if performed), and evidence of other causes being ruled out.

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