M04 — Autoinflammatory syndromes
Is M04 billable?
No — M04 is a non-billable header code. M04 groups more specific codes and cannot be submitted on a claim. A valid ICD-10-CM code must be reported at the highest level of specificity available in its branch. Select one of the 5 billable codes beneath M04.
M04 at a glance
| Code | M04 |
|---|---|
| Description | Autoinflammatory syndromes |
| Billable | No — header code |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Excludes2 — not included here
The conditions below are not part of M04, but a patient may have both at the same time. When documentation supports it, M04 and the excluded code may both be reported.
- Crohn's disease (K50.-)
Excludes2 — not included here — inherited from Chapter 13
The conditions below are not part of M04, but a patient may have both at the same time. When documentation supports it, M04 and the excluded code may both be reported.
- 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)
What codes fall under M04? (5)
How long has M04 existed?
M04 first appears in FY2018 (FY2017 is not available, so it may have appeared then).
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.