M35.81

Multisystem inflammatory syndrome

Billable / specificHCC V28 2

M35.81 is a billable, specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes in FY2027.

Inclusion terms

Applicable to

  • MIS-A
  • MIS-C
  • Multisystem inflammatory syndrome in adults
  • Multisystem inflammatory syndrome in children
  • Pediatric inflammatory multisystem syndrome
  • PIMS

Includes (from M35)

  • autoimmune disease NOS
  • collagen (vascular) disease NOS
  • systemic autoimmune disease
  • systemic collagen (vascular) disease
  • Note: Use an external cause code following the code for the musculoskeletal condition, if applicable, to identify the cause of the musculoskeletal condition

Excludes1

Not coded here — never report together with this code.

  • autoimmune disease, single organ or single cell-type -code to relevant condition category (from M35)
  • reactive perforating collagenosis (L87.1) (from M35)

Excludes2

Not included here — may be reported together when both conditions exist.

  • arthropathic psoriasis (L40.5-) (from M35)
  • certain conditions originating in the perinatal period (P04-P96) (from M35)
  • certain infectious and parasitic diseases (A00-B99) (from M35)
  • compartment syndrome (traumatic) (T79.A-) (from M35)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A) (from M35)
  • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99) (from M35)
  • endocrine, nutritional and metabolic diseases (E00-E88) (from M35)
  • injury, poisoning and certain other consequences of external causes (S00-T88) (from M35)
  • neoplasms (C00-D49) (from M35)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94) (from M35)

Code first

Sequence the underlying condition first.

  • , if applicable, COVID-19 (U07.1)

Use additional code

Add a code to identify the following, if applicable.

  • code, if applicable, for:
  • exposure to COVID-19 or SARS-CoV-2 infection (Z20.822)
  • personal history of COVID-19 (Z86.16)
  • post COVID-19 condition (U09.9)

Code also

An additional code may be needed.

  • any associated complications such as:
  • acute hepatic failure (K72.0-)
  • acute kidney failure (N17.-)
  • acute myocarditis (I40.-)
  • acute respiratory distress syndrome (J80)
  • cardiac arrhythmia (I47-I49.-)
  • pneumonia due to COVID-19 (J12.82)
  • severe sepsis (R65.2-)
  • viral cardiomyopathy (B33.24)
  • viral pericarditis (B33.23)

Also known as

  • MIS-A
  • MIS-C
  • Multisystem inflammatory syndrome in adults
  • Multisystem inflammatory syndrome in children
  • Pediatric inflammatory multisystem syndrome
  • PIMS
  • Syndrome, multisystem inflammatory
  • Syndrome, pediatric inflammatory multisystem

Parent code

  • M35.8Other specified systemic involvement of connective tissueHeader

Related codes

  • M35.89Other specified systemic involvement of connective tissueBillable

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