M35.03 — Sjogren syndrome with myopathy
M35.03 is a billable, specific ICD-10-CM code for sjogren syndrome with myopathy. It is valid for submission on a claim.
Other codes that can never be billed with M35.03
These codes carry an Excludes1 note pointing at M35.03. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading M35.03 alone.
- G73.7Myopathy in diseases classified elsewhere
Risk adjustment
M35.03 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
M35.03 is named in 23 Medicare coverage policies — 17 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 M35.03 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 M35.03.
- Myopathy›in›sicca syndrome
- Myopathy›in›Sjögren's syndrome
- Syndrome›Sjögren›with›myopathy
Related codes at this level
Codes that share M35.0. If M35.03 is not quite right, the correct code is usually one of these.
- M35.00Sjogren syndrome, unspecified
- M35.01Sjogren syndrome with keratoconjunctivitis
- M35.02Sjogren syndrome with lung involvement
- M35.04Sjogren syndrome with tubulo-interstitial nephropathy
- M35.05Sjogren syndrome with inflammatory arthritis
- M35.06Sjogren syndrome with peripheral nervous system involvement
- M35.07Sjogren syndrome with central nervous system involvement
- M35.08Sjogren syndrome with gastrointestinal involvement
- M35.0ASjogren syndrome with glomerular disease
- M35.0BSjogren syndrome with vasculitis
- M35.0CSjogren syndrome with dental involvement
- M35.09Sjogren syndrome with other organ involvement
Questions about M35.03
- Is M35.03 a billable ICD-10-CM code?
- Yes. M35.03 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does M35.03 sit in the tabular list?
- Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Systemic connective tissue disorders (M30-M36).