Is M35.1 a billable ICD-10-CM code?

Yes. M35.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does M35.1 sit in the tabular list?

Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Systemic connective tissue disorders (M30-M36).

What cannot be coded together with M35.1?

M35.1 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

M35.1

M35.1 — Other overlap syndromes

Billable / specific codeICD-10-CM

M35.1 is a billable, specific ICD-10-CM code for other overlap syndromes. 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.

polyangiitis overlap syndrome (M30.8)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Mixed connective tissue disease

Risk adjustment

M35.1 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

M35.1 is named in 7 Medicare coverage policies — 1 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 M35.1 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 M35.1.

Disease, diseased›mixed connective tissue
Syndrome›connective tissue›overlap NEC

Related codes at this level

Codes that share M35. If M35.1 is not quite right, the correct code is usually one of these.

Questions about M35.1

Is M35.1 a billable ICD-10-CM code?: Yes. M35.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does M35.1 sit in the tabular list?: Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Systemic connective tissue disorders (M30-M36).
What cannot be coded together with M35.1?: M35.1 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.