Is ICD-10-CM code M34 billable?

No, M34 (Systemic sclerosis [scleroderma]) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code M34 belong to?

M34 belongs to Chapter 13 of the ICD-10-CM tabular list: M00–M99 (Diseases of the Musculoskeletal System and Connective Tissue).

M34Not billable, use a more specific code below

Systemic sclerosis [scleroderma]

In Systemic connective tissue disorders (M30-M36), chapter 13: Diseases of the Musculoskeletal System and Connective Tissue

8 billable codes under M34: 2 are a CC; 7 map to HCC 93 (Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders), HCC 278 (Idiopathic Pulmonary Fibrosis and Lung Involvement in Systemic Sclerosis).A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment. An HCC counts toward a Medicare Advantage patient's risk score.

Instructional notes

Excludes1: not coded here, use a different code

circumscribed scleroderma (L94.0)
neonatal scleroderma (P83.88)

Also applies, from Systemic connective tissue disorders (M30-M36)

These notes sit on M30-M36 and apply to every code under it, including M34.

Includes: conditions that are coded here

autoimmune disease NOS
collagen (vascular) disease NOS
systemic autoimmune disease
systemic collagen (vascular) disease

Excludes1: not coded here, use a different code

autoimmune disease, single organ or single cell-type -code to relevant condition category

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Covers site and laterality, acute injury versus chronic musculoskeletal conditions, 7th characters for pathologic fractures, osteoporosis with or without current fracture, and multisystem inflammatory syndrome.

Site and laterality (page 60)
Acute traumatic versus chronic or recurrent musculoskeletal conditions (page 61)
Coding of Pathologic Fractures (page 61)
Osteoporosis (page 61)
Multisystem Inflammatory Syndrome (page 62)

Read Section I.C.13 (page 60)

All codes under M34

M34 can't be used on a claim. Pick a billable code below; grey headings group them.

M34 MS-DRGs

As the principal diagnosis, the billable codes under M34 group to these 8 MS-DRGs (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 545 Connective Tissue Disorders with MCC (6 of 8 codes)
DRG 546 Connective Tissue Disorders with CC (6 of 8 codes)
DRG 547 Connective Tissue Disorders without CC/MCC (6 of 8 codes)
DRG 073 Cranial and Peripheral Nerve Disorders with MCC (1 of 8 codes)
DRG 074 Cranial and Peripheral Nerve Disorders without MCC (1 of 8 codes)
DRG 196 Interstitial Lung Disease with MCC (1 of 8 codes)
DRG 197 Interstitial Lung Disease with CC (1 of 8 codes)
DRG 198 Interstitial Lung Disease without CC/MCC (1 of 8 codes)

Other codes that refer to M34

Notes on these codes point to M34.

I27.21 Code Also: systemic sclerosis (M34.-)
K31.84 Code First: scleroderma (M34.-)
L93 Excludes1: scleroderma (M34.-)
M60-M63 Excludes1: myopathy in scleroderma (M34.-)

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Scleroderma

Scleroderma means "hard skin." It's the name of an autoimmune disease that causes inflammation and thickening in the skin and other areas of the body. This inflammation causes you to have areas of tight, hard skin. Scleroderma may affect just one area of your body, or it can affect many systems in your body.

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.