M30-M36 — Systemic connective tissue disorders
ICD-10-CM codes M30-M36 cover systemic connective tissue disorders, within diseases of the musculoskeletal system and connective tissue. The block holds 101 codes across 7 categories, of which 84 are billable and 17 are header codes that cannot be submitted on a claim.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- autoimmune disease, single organ or single cell-type -code to relevant condition category
Includes
Conditions this code covers.
- autoimmune disease NOS
- collagen (vascular) disease NOS
- systemic autoimmune disease
- systemic collagen (vascular) disease
Risk adjustment in M30-M36
0 codes in this block map to a CMS-HCC, which means the diagnosis carries a risk-adjustment payment when it is documented and coded. Under-coding here is money left on the table; over-coding here is what audits are for.
- HCC 93 Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders
- HCC 94 Systemic Lupus Erythematosus and Other Specified Systemic Connective Tissue Disorders
- HCC 280 Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders
- HCC 112 Immune Thrombocytopenia and Specified Coagulation Defects and Hemorrhagic Conditions
- HCC 278 Idiopathic Pulmonary Fibrosis and Lung Involvement in Systemic Sclerosis
- HCC 2 Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock
What else to watch in M30-M36
- 84 codes are named in Medicare coverage policies. An LCD or NCD lists them as supporting medical necessity, or explicitly as not supporting it. Which applies depends on the MAC for your state.
Categories in M30-M36
- M30Polyarteritis nodosa and related conditions
- M31Other necrotizing vasculopathies
- M32Systemic lupus erythematosus (SLE)
- M33Dermatopolymyositis
- M34Systemic sclerosis [scleroderma]
- M35Other systemic involvement of connective tissue
- M36Systemic disorders of connective tissue in diseases classified elsewhere