M06.1 — Adult-onset Still's disease
M06.1 is a billable, specific ICD-10-CM code for adult-onset still's disease. It is valid for submission on a claim.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- Still's disease NOS (M08.2-)
Other codes that can never be billed with M06.1
These codes carry an Excludes1 note pointing at M06.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading M06.1 alone.
- M08.2Juvenile rheumatoid arthritis with systemic onset
Risk adjustment
M06.1 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 93 Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders0.617 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
M06.1 is named in 29 Medicare coverage policies — 23 listing it as supporting medical necessity, and 6 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A58865Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A58893Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A59374Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A59434Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
How M06.1 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to M06.1.
- Still's disease or syndrome›adult-onset
Related codes at this level
Codes that share M06. If M06.1 is not quite right, the correct code is usually one of these.
Questions about M06.1
- Is M06.1 a billable ICD-10-CM code?
- Yes. M06.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does M06.1 sit in the tabular list?
- Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Inflammatory polyarthropathies (M05-M14).
- What cannot be coded together with M06.1?
- M06.1 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.