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New ICD-10-CM Diagnosis Code G11.11 for Friedreich’s Ataxia Effective October 1, 2020

A new diagnosis code has been approved for Friedreich’s ataxia by the Centers of Medicare and Medicaid Services (CMS), effective October 1, 2020. The new code, ICD-10-CM G11.11, is to be used by clinicians to document the Friedreich’s Ataxia (FA) diagnosis in medical records and is used by health insurance companies to determine coverage approval for claims.

The International Classification of Diseases (ICD) coding system was established by the World Health Organization; currently used by ~100 countries for reporting cause of death and other epidemiology statistics. The system contains codes for diseases, symptoms, abnormal findings, social circumstances, and external causes of injury. ICD-10-CM codes, or diagnosis codes, are used by clinicians to document the need for healthcare services.

When the U.S. converted from ICD-9 to ICD-10 in 2015, the code for FA became less specific because it covered a group of conditions described as “early-onset cerebellar ataxias”. The Friedreich’s Ataxia Research Alliance (FARA), along with physicians in the Collaborative Clinical Research Network in FA, recognized a need for greater specificity and initiated the request for an FA specific code.

FARA Chief Executive Officer, Jennifer Farmer said, “We believe the new FA specific ICD-10 code G11.11 will lead to fewer rejected health insurance claims, help monitor outcomes of clinical management guidelines, and enhance ability to evaluate symptom progression and track disease prevalence.”

Fact sheets regarding use of the new ICD-10 code G11.11 are available for patients and clinicians at curefa.org/care

 

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