ICD-10-CM · General

M35.02

Sjögren syndrome with documented pulmonary manifestations, classified under systemic connective tissue disorders in ICD-10-CM Chapter 13.

Verified May 8, 2026 · 4 sources ↓

Status
Billable
Chapter
13
Related CPT
5
Region
General
Drawn from CDCICD10DataCMSAAPC

Documentation tips

What should appear in the chart to support M35.02.

Source · Editorial brief grounded in 4 cited references ↓

  • Explicitly link the pulmonary finding (e.g., interstitial lung disease, lymphocytic interstitial pneumonitis) to Sjögren syndrome — a vague mention of 'lung involvement' without causal attribution to the autoimmune condition is insufficient.
  • Record diagnostic imaging results that support pulmonary involvement, such as HRCT findings of ground-glass opacities, honeycombing, or reticular patterns, with a provider statement connecting findings to Sjögren syndrome.
  • Document pulmonary function test results (spirometry, DLCO) if performed — these support the severity classification that drives MCC/CC DRG assignment.
  • If multiple organ systems are involved (e.g., eyes, kidneys, lungs), document each manifestation separately so that additional M35.0x codes can be assigned alongside M35.02.
  • Note whether the lung involvement is newly diagnosed, progressing, or stable — this context supports medical necessity for ongoing pulmonology or rheumatology services billed under this diagnosis.

Related CPT procedures

Procedure codes commonly billed with M35.02. Linking the right diagnosis to the right procedure is what establishes medical necessity.

Source · CMS LCDs · AAOS specialty guidance · claims-pattern analysis

Common coding pitfalls

The recurring mistakes coders make with M35.02 and adjacent codes.

Source · Editorial brief grounded in CDC ICD-10-CM tabular guidance, AAOS coding references, and cited references ↓

  • Using M35.09 (Other Sjögren syndrome) when lung involvement is specifically documented — M35.02 is the correct specific code and should not be bypassed in favor of the catch-all subcategory.
  • Assigning a separate respiratory code (e.g., J84.x for interstitial lung disease) as the primary code when the lung disease is a documented manifestation of Sjögren syndrome — M35.02 captures both the underlying condition and the organ involvement in a single billable code.
  • Confusing M35.02 with codes for primary interstitial or autoimmune lung disease not associated with Sjögren syndrome — the diagnosis of Sjögren syndrome must be confirmed in the record, not inferred.
  • Failing to code additional M35.0x manifestation codes when multiple organ systems are involved, leaving the full disease burden undocumented and potentially undercoding the encounter's complexity.

Clinical context

Source · Editorial summary grounded in 4 cited references ↓

M35.02 is the correct code when a patient carries a confirmed Sjögren syndrome diagnosis and has pulmonary involvement — such as interstitial lung disease, lymphocytic interstitial pneumonitis, bronchiolitis, or pleuritis — documented as part of the systemic autoimmune process. This code was revised in FY2022 from its prior description 'Sicca syndrome with lung involvement' to the current 'Sjögren syndrome with lung involvement'; do not use the old sicca syndrome terminology to select this code if the updated classification applies.

M35.02 falls under parent code M35.0 (Sjögren syndrome), which groups into MS-DRG v43.0 categories 545–547 (Connective tissue disorders with MCC, with CC, or without CC/MCC). The lung involvement documented in the record drives the MCC/CC assignment, so specificity in documentation directly affects DRG weight and reimbursement.

Per ICD-10-CM Official Guidelines Section I.C.15 on syndromes, follow the Alphabetic Index for Sjögren syndrome. When lung involvement has a unique code like M35.02, assign that code rather than stacking separate manifestation codes for the pulmonary finding. If additional complications are present that are not captured by M35.02 alone (e.g., sicca keratoconjunctivitis, renal involvement), assign supplemental codes from the M35.0x subcategory as appropriate.

Sibling codes

Other billable codes under M35.0 (laterality / anatomic variants).

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 4 cited references ↓

01Can I use M35.02 alongside a separate ICD-10 code for interstitial lung disease?
Generally no. When the interstitial lung disease is documented as a manifestation of Sjögren syndrome, M35.02 is the single code that captures both. Assign a separate J84.x code only if the pulmonary condition is documented as a distinct, independently existing diagnosis unrelated to the Sjögren process.
02What changed when M35.02 was revised in FY2022?
The code description changed from 'Sicca syndrome with lung involvement' to 'Sjögren syndrome with lung involvement.' The code number itself did not change. Coders using the prior sicca syndrome terminology should confirm the updated description applies when selecting this code for FY2022 and later encounters.
03Is M35.02 appropriate if Sjögren syndrome is suspected but not yet confirmed?
No. ICD-10-CM guidelines require a confirmed diagnosis for code assignment in outpatient settings. If Sjögren syndrome is suspected but unconfirmed, code the presenting signs and symptoms instead — do not assign M35.02 on the basis of clinical suspicion alone.
04How does M35.02 interact with other M35.0x subcategory codes?
Multiple M35.0x codes can be assigned together when Sjögren syndrome involves more than one organ system. For example, M35.02 (lung) can be coded alongside M35.01 (keratoconjunctivitis) or M35.04 (tubulo-interstitial nephropathy) when documentation supports each manifestation.
05Which MS-DRGs does M35.02 map to?
M35.02 groups to MS-DRG v43.0 categories 545 (Connective tissue disorders with MCC), 546 (with CC), and 547 (without CC/MCC). Thorough documentation of pulmonary severity can qualify the lung involvement as an MCC or CC, directly affecting DRG weight.
06Does M35.02 require a 7th character extension?
No. M35.02 is an M-code (musculoskeletal/connective tissue chapter) and does not use 7th-character extensions. It is a fully specified, billable 5-character code as listed in the FY2026 ICD-10-CM Tabular List.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

  1. 01CDC ICD-10-CM Tabular List 2026 (effective October 1, 2025)
  2. 02
    icd10data.com
    https://www.icd10data.com/ICD10CM/Codes/M00-M99/M30-M36/M35-/M35.02
  3. 03
    cms.gov
    https://www.cms.gov/files/document/fy-2025-icd-10-cm-coding-guidelines.pdf
  4. 04
    aapc.com
    https://www.aapc.com/codes/icd-10-codes/M35.02

Mira AI Scribe

The Mira AI Scribe captures the treating provider's explicit linkage between Sjögren syndrome and pulmonary findings — including HRCT or PFT results, specific pulmonary diagnosis (e.g., ILD, lymphocytic interstitial pneumonitis), and disease progression status. This prevents down-coding to M35.09 or miscoding to a primary respiratory code, and preserves the MCC/CC DRG assignment that lung involvement supports.

See how Mira captures M35.02 documentation

Related ICD-10 codes

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