M04.8 — Other autoinflammatory syndromes
Is M04.8 billable?
Yes — M04.8 is billable for FY2027. M04.8 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. M04.8 may be submitted for encounters from October 1, 2026 through September 30, 2027.
M04.8 at a glance
| Code | M04.8 |
|---|---|
| Description | Other autoinflammatory syndromes |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Which MS-DRGs does M04.8 group to?
M04.8 sits in MDC 08 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 545Connective Tissue Disorders with MCCmedical
- 546Connective Tissue Disorders with CCmedical
- 547Connective Tissue Disorders without CC/MCCmedical
How is M04.8 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to M04.8. They show the wording a clinician may have documented, which often differs from the Tabular description.
- DIRA (deficiency of interleukin 1 receptor antagonist)
- PAPA (pyogenic arthritis, pyoderma gangrenosum, and acne syndrome)
- PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and adenopathy syndrome)
- Deficiency, deficient › of interleukin 1 receptor antagonist [DIRA]
- Syndrome › Blau
- Syndrome › Majeed
- Syndrome › periodic fever, aphthous stomatitis, pharyngitis, and adenopathy [PFAPA]
- Syndrome › pyogenic arthritis, pyoderma gangrenosum, and acne [PAPA]
- Syndrome › Yao
- Disease, diseased › autoinflammatory › NOD2-associated
- Disease, diseased › autoinflammatory › specified type NEC
- Syndrome › autoinflammatory › specified type NEC
Inclusion terms
Alternative wording in documentation that is classified to M04.8.
- Blau syndrome
- Deficiency of interleukin 1 receptor antagonist [DIRA]
- Majeed syndrome
- Periodic fever, aphthous stomatitis, pharyngitis, and adenopathy syndrome [PFAPA]
- Pyogenic arthritis, pyoderma gangrenosum, and acne syndrome [PAPA]
Excludes2 — not included here — inherited from Chapter 13
The conditions below are not part of M04.8, but a patient may have both at the same time. When documentation supports it, M04.8 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)
Excludes2 — not included here — inherited from M04
The conditions below are not part of M04.8, but a patient may have both at the same time. When documentation supports it, M04.8 and the excluded code may both be reported.
- Crohn's disease (K50.-)
How long has M04.8 existed?
M04.8 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.