M35.6

M35.6: Relapsing panniculitis [Weber-Christian]

Billable / specific codeICD-10-CM

M35.6 is a billable, specific ICD-10-CM code for relapsing panniculitis [weber-christian]. It is valid for submission on a claim.

Check M35.6 with the rest of the claim: free scrubber

Excludes1: never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

lupus panniculitis (L93.2)
panniculitis NOS (M79.3-)

Excludes1 inherited from the categories above M35.6

A category’s note binds every code beneath it.

Written on M35: Other systemic involvement of connective tissue

reactive perforating collagenosis (L87.1)

Other codes that can never be billed with M35.6

Their own Excludes1 notes name this code, so the conflict is not listed above.

L95Vasculitis limited to skin, not elsewhere classified
M54.0Panniculitis affecting regions of neck and back
M79.3Panniculitis, unspecified

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

M35.6 is named in 8 Medicare coverage policies: 1 listing it as supporting medical necessity, and 7 listing it as NOT covered. Which one applies depends on your Medicare contractor.

A58865Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
A58883Billing 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