ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 M30.8

Billable / Specific HCC v28: 40 CC

Other conditions related to polyarteritis nodosa

M30
Block
1
Synonyms
222
LCDs
20
Payer Policies
0
Linked CPTs

About ICD-10-CM M30.8

ICD-10-CM code M30.8 represents Other conditions related to polyarteritis nodosa. This is a billable/specific code in the Musculoskeletal and Connective Tissue chapter (block M30). The 2026 edition of ICD-10-CM M30.8 became effective on October 1, 2025.

Coding Tips for M30.8

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

HCC capture: document with MEAT each year

M30.8 is a CMS-HCC v28 risk-adjustment code (category 40). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.

Inpatient DRG impact: CC

M30.8 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under M30.8. Per CMS ICD-10-CM Tabular 2026.

  • Polyangiitis overlap syndrome

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 40
ESRD-HCC
Category 40
RxHCC (Part D)
Category 40

Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.

Inpatient DRG Impact, CC

codes Other conditions related to polyarteritis nodosa. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for M30.8

Local Coverage Determinations (LCDs) from CMS MACs that list M30.8 as a covered diagnosis.

222 LCDs

Showing top 10 of 222 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Non-Invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities
Article ID: 60318, Effective: , 409 covered, 1 non-covered
CPT 93926 →
CMS LCD: Billing and Coding: Non-Invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities
Article ID: 60318, Effective: , 409 covered, 1 non-covered
CPT 93930 →
CMS LCD: Billing and Coding: Non-Invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities
Article ID: 60318, Effective: , 409 covered, 1 non-covered
CPT 93925 →
CMS LCD: Billing and Coding: Non-Invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities
Article ID: 60318, Effective: , 409 covered, 1 non-covered
CPT 93931 →
CMS LCD: Billing and Coding: Non-Invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities
Article ID: 60314, Effective: , 409 covered, 1 non-covered
CPT 93926 →
CMS LCD: Billing and Coding: Non-Invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities
Article ID: 60314, Effective: , 409 covered, 1 non-covered
CPT 93930 →
CMS LCD: Billing and Coding: Non-Invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities
Article ID: 60314, Effective: , 409 covered, 1 non-covered
CPT 93925 →
CMS LCD: Billing and Coding: Non-Invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities
Article ID: 60314, Effective: , 409 covered, 1 non-covered
CPT 93931 →
CMS LCD: Billing and Coding: Sedimentation Rate, Erythrocyte
Article ID: 57657, Effective: 2024-10-01 00:00:00, 1430 covered, 1 non-covered
CPT 85651 →
CMS LCD: Billing and Coding: Sedimentation Rate, Erythrocyte
Article ID: 57657, Effective: 2024-10-01 00:00:00, 1430 covered, 1 non-covered
CPT 85652 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing M30.8.

20 policies

1 Cigna

Transthoracic Echocardiography in Children - (0523)
Policy ID: MM_0523

5 Medicare

Billing and Coding: Chemotherapy Agents for Non-Oncologic Conditions
Policy ID: ART-55639
Billing and Coding: Rituximab
Policy ID: ART-56380
Billing and Coding: Echocardiography
Policy ID: ART-56625
Billing and Coding: Thoracic Aortography and Carotid, Vertebral, and Subclavian Angiography
Policy ID: ART-56631
Billing and Coding: Outpatient Speech Language Pathology
Policy ID: ART-56868

CPT Codes Commonly Billed with M30.8

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for M30.8

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Convert M30.8 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
M30.8 4460 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 M30.8, Billing FAQ

Is ICD-10 code M30.8 billable? +

Yes, M30.8 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to M30.8? +

ICD-10 M30.8 includes: Polyangiitis overlap syndrome.

Does M30.8 affect Medicare Advantage HCC risk adjustment? +

Yes. M30.8 maps to CMS-HCC v28 category 40. Capture this diagnosis annually for accurate Medicare Advantage risk score.

Is M30.8 a CC or MCC for inpatient DRG? +

Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.

What ICD-9 codes does M30.8 map to? +

Per CMS GEMs, M30.8 maps to ICD-9 codes: 4460. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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