M36.4 — Arthropathy in hypersensitivity reactions classified elsewhere
M36.4 is a billable, specific ICD-10-CM code for arthropathy in hypersensitivity reactions classified elsewhere. It is valid for submission on a claim.
Other codes that can never be billed with M36.4
These codes carry an Excludes1 note pointing at M36.4. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading M36.4 alone.
- M14Arthropathies in other diseases classified elsewhere
Risk adjustment
M36.4 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
M36.4 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 M36.4 is not quite right, the correct code is usually one of these.
Questions about M36.4
- Is M36.4 a billable ICD-10-CM code?
- Yes. M36.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does M36.4 sit in the tabular list?
- Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Systemic connective tissue disorders (M30-M36).