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

ICD-10 M35.0A

Billable / Specific

Sjogren syndrome with glomerular disease

M35
Block
0
Synonyms
56
LCDs
7
Payer Policies
0
Linked CPTs

About ICD-10-CM M35.0A

ICD-10-CM code M35.0A represents Sjogren syndrome with glomerular disease. This is a billable/specific code in the Musculoskeletal and Connective Tissue chapter (block M35). The 2026 edition of ICD-10-CM M35.0A became effective on October 1, 2025.

Medicare Advantage HCC Impact

ESRD-HCC
Category 141

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

Medicare LCD Coverage for M35.0A

Local Coverage Determinations (LCDs) from CMS MACs that list M35.0A as a covered diagnosis.

56 LCDs

Showing top 10 of 56 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74170 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74177 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74160 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74178 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74150 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72194 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74176 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72192 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72193 →
CMS LCD: Billing and Coding: Chemotherapy Agents for Non-Oncologic Conditions
Article ID: 55639, Effective: 2025-11-27 00:00:00, 564 covered, 0 non-covered
CPT Q5119 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing M35.0A.

7 policies

1 Cigna

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

5 Medicare

Billing and Coding: Retroperitoneal Ultrasound
Policy ID: ART-55336
Billing and Coding: Chemotherapy Agents for Non-Oncologic Conditions
Policy ID: ART-55639
Billing and Coding: Rituximab
Policy ID: ART-56380
Billing and Coding: CT of the Abdomen and Pelvis
Policy ID: ART-56421
Billing and Coding: Serum Magnesium
Policy ID: ART-57189

CPT Codes Commonly Billed with M35.0A

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

No procedure linkages on file for M35.0A

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.

ICD-10 M35.0A, Billing FAQ

Is ICD-10 code M35.0A billable? +

Yes, M35.0A is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on June 1, 2026.

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