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M36.1

M36.1Arthropathy in neoplastic disease

Billable / specific codeICD-10-CM

M36.1 is a billable, specific ICD-10-CM code for arthropathy in neoplastic disease. It is valid for submission on a claim.

Code first

The underlying condition must be sequenced before this code.

  • underlying neoplasm, such as:
  • leukemia (C91-C95)
  • malignant histiocytosis (C96.A)
  • multiple myeloma (C90.0)

Other codes that can never be billed with M36.1

These codes carry an Excludes1 note pointing at M36.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading M36.1 alone.

  • M14Arthropathies in other diseases classified elsewhere

Risk adjustment

M36.1 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

M36.1 is named in 6 Medicare coverage policies 0 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

Related codes at this level

Codes that share M36. If M36.1 is not quite right, the correct code is usually one of these.

Questions about M36.1

Is M36.1 a billable ICD-10-CM code?
Yes. M36.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does M36.1 sit in the tabular list?
Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Systemic connective tissue disorders (M30-M36).
ICD-10-CMFY2026-Apr· effective April 1, 2026

Loaded directly from the CMS/NCHS ICD-10-CM public-domain release — see data sources and our editorial policy. If this page disagrees with the CMS tabular list, this page is wrong. Reference information for professional coders; not medical or billing advice.