M04

Non-Billable

ChapterM00–M99

Rankcategory

Official Description

Autoinflammatory syndromes

Use a more specific code (4 billable)

Metadata & Insights

•Non-billable category (requires more specific sub-code).
•Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue (M00-M99).

Excludes2(Not included here. Code separately if applicable.)

arthropathic psoriasis (L40.5-)
certain conditions originating in the perinatal period (P04-P96)
certain infectious and parasitic diseases (A00-B99)
compartment syndrome (traumatic) (T79.A-)
complications of pregnancy, childbirth and the puerperium (O00-O9A)
congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
endocrine, nutritional and metabolic diseases (E00-E88)
injury, poisoning and certain other consequences of external causes (S00-T88)
neoplasms (C00-D49)
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

Excludes2(Not included here. Code separately if applicable.)

BillableHas subcodes

CH13Diseases of the musculoskeletal system and connective tissue (M00-M99)

M04Autoinflammatory syndromesNot billable

M04.1Periodic fever syndromesBillable

M04.2Cryopyrin-associated periodic syndromesBillable

M04.8Other autoinflammatory syndromesBillable

M04.9Autoinflammatory syndrome, unspecifiedBillable

The following parent sections contain instructions or notes that apply to M04:

chapterCH13

Diseases of the musculoskeletal system and connective tissue (M00-M99)

2026

No direct MS-DRG triggers identified.

Find surgical and procedural codes related to Autoinflammatory syndromes.