M34.81 — Systemic sclerosis with lung involvement
M34.81 is a billable, specific ICD-10-CM code for systemic sclerosis with lung involvement. It is valid for submission on a claim.
Other codes that can never be billed with M34.81
These codes carry an Excludes1 note pointing at M34.81. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading M34.81 alone.
- J99Respiratory disorders in diseases classified elsewhere
Risk adjustment
M34.81 risk-adjusts. Under the CMS-HCC V28 model it maps to these categories:
- HCC 93 Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders0.617 RAF
- HCC 278 Idiopathic Pulmonary Fibrosis and Lung Involvement in Systemic Sclerosis0.818 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
M34.81 is named in 17 Medicare coverage policies — 11 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 M34.81 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 M34.81.
- Sclerosis, sclerotic›systemic›with›lung involvement
- Disease, diseased›lung›in›systemic›sclerosis
Related codes at this level
Codes that share M34.8. If M34.81 is not quite right, the correct code is usually one of these.
Questions about M34.81
- Is M34.81 a billable ICD-10-CM code?
- Yes. M34.81 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does M34.81 sit in the tabular list?
- Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Systemic connective tissue disorders (M30-M36).