ICD-10 Coding for Sjogren's Disease(M35.01, M35.02)
Complete ICD-10-CM coding and documentation guide for Sjogren's Disease. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Sjogren's Disease
M35.00-M35.04Primary Range
Sjögren's syndrome with specific organ involvement
This range covers Sjögren's disease with various manifestations, requiring specific documentation for each organ involved.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M35.01 | Sjögren's syndrome with keratoconjunctivitis | Use when Sjögren's disease presents with ocular involvement confirmed by clinical tests. |
|
| M35.02 | Sjögren's syndrome with lung involvement | Use when Sjögren's disease presents with pulmonary manifestations confirmed by imaging. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for Sjogren's disease
Essential facts and insights about Sjogren's Disease
Primary ICD-10-CM Codes for sjogren's disease
Decision Criteria
clinical Criteria
- Presence of keratoconjunctivitis with Sjögren's
Applicable To
- Keratoconjunctivitis sicca
Excludes
- Dry eye syndrome (H04.12)
Clinical Validation Requirements
- Abnormal Schirmer's test ≤5mm/5min
- Positive anti-SSA/Ro antibodies
Code-Specific Risks
- Misclassification if ocular involvement is not documented.
Coding Notes
- Ensure documentation specifies keratoconjunctivitis as part of Sjögren's.
M35.02 - Sjögren's syndrome with lung involvement
Use when Sjögren's disease presents with pulmonary manifestations confirmed by imaging.
Applicable To
- Interstitial lung disease
- Lymphocytic bronchiolitis
Excludes
- Pulmonary sarcoidosis (D86.0)
Clinical Validation Requirements
- HRCT showing interstitial lung disease
- Negative HCV tests
Coding Notes
Document specific lung involvement clearly.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Sjogren's Disease to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M35.01.
Impact
Clinical: Miscommunication of diagnosis, Regulatory: Non-compliance with updated coding standards, Financial: Potential claim denials
Mitigation Strategy
Educate staff on current terminology, Regularly update EHR templates
Impact
Reimbursement: Potential underpayment due to lack of specificity., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Always specify and document the organ involvement to use the correct code.
Impact
Audits may focus on whether specific organ involvement is documented.
Mitigation Strategy
Ensure all relevant clinical tests and findings are documented.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Sjogren's Disease, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Sjogren's Disease
Use these documentation templates to ensure complete and accurate documentation for Sjogren's Disease. These templates include all required elements for proper coding and billing.
Rheumatology Consultation
Specialty: RheumatologyRequired Elements
- Symptoms duration
- Objective tests
- Autoantibodies
- Biopsy results
- Exclusions
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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