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  6. 2025 ICD-10-CM Code M04

2025 ICD-10-CM Diagnosis Code M04

Autoinflammatory syndromes

ICD-10-CM Code:
M04
ICD-10 Code for:
Autoinflammatory syndromes
Is Billable?
Not Valid for Submission
Code Navigator:

M04 is a non-specific and non-billable diagnosis code code, consider using a code with a higher level of specificity for a diagnosis of autoinflammatory syndromes. The code is not specific and is NOT valid for the year 2025 for the submission of HIPAA-covered transactions. Category or Header define the heading of a category of codes that may be further subdivided by the use of 4th, 5th, 6th or 7th characters.

Specific Coding Applicable to Autoinflammatory syndromes

Non-specific codes like M04 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10-CM codes with a higher level of specificity when coding for autoinflammatory syndromes:

  • Use M04.1 for Periodic fever syndromes - BILLABLE CODE

  • Use M04.2 for Cryopyrin-associated periodic syndromes - BILLABLE CODE

  • Use M04.8 for Other autoinflammatory syndromes - BILLABLE CODE

  • Use M04.9 for Autoinflammatory syndrome, unspecified - BILLABLE CODE

Code Classification

  • Diseases of the musculoskeletal system and connective tissue
    M00–M99
    • Autoinflammatory syndromes
      M04
      • Autoinflammatory syndromes
        M04

Tabular List of Diseases and Injuries

The following annotation back-references are applicable to this diagnosis code. The Tabular List of Diseases and Injuries is a list of ICD-10-CM codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more.


Type 2 Excludes

Type 2 Excludes
A type 2 excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
  • Crohn's disease K50

Patient Education


Autoimmune Diseases

What are autoimmune diseases?

Your immune system protects you from disease and infection by attacking germs that get into your body, such as viruses and bacteria. Your immune system can tell that the germs aren't part of you, so it destroys them. If you have an autoimmune disease, your immune system attacks the healthy cells of your organs and tissues by mistake.

There are more than 80 types of autoimmune diseases. They can affect almost any part of your body. For example, alopecia areata is an autoimmune disease of the skin that causes hair loss. Autoimmune hepatitis affects the liver. In type 1 diabetes, the immune system attacks the pancreas. And in rheumatoid arthritis, the immune system can attack many parts of the body, including the joints, lungs, and eyes.

What causes autoimmune diseases?

No one is sure why autoimmune diseases happen. But you can't catch them from other people.

Autoimmune diseases do tend to run in families, which means that certain genes may make some people more likely to develop a problem. Viruses, certain chemicals, and other things in the environment may trigger an autoimmune disease if you already have the genes for it.

Who is at risk for autoimmune diseases?

Millions of Americans of all ages have autoimmune diseases. Women develop many types of autoimmune diseases much more often than men. And if you have one autoimmune disease, you are more likely to get another.

What are the symptoms of autoimmune diseases?

The symptoms of an autoimmune disease depend on the part of your body that's affected. Many types of autoimmune diseases cause redness, swelling, heat, and pain, which are the signs and symptoms of inflammation. But other illnesses can cause the same symptoms.

The symptoms of autoimmune diseases can come and go. During a flare-up, your symptoms may get severe for a while. Later on, you may have a remission, which means that your symptoms get better or disappear for a period of time.

How are autoimmune diseases diagnosed?

Doctors often have a hard time diagnosing autoimmune diseases. There's usually not a specific test to show whether you have a certain autoimmune disease. And the symptoms can be confusing. That's because many autoimmune diseases have similar symptoms. And some symptoms, such as muscle aches, are common in many other illnesses. So it can take a long time and some visits to different types of doctors to get a diagnosis.

To help your doctor find out if an autoimmune disease is causing your symptoms,:

  • Learn about the health conditions in your family history. What health problems did your grandparents, aunts, uncles, and cousins have? Write down what you learn and share it with your doctor.
  • Keep track of your symptoms, including how long they last and what makes them better or worse. Share your notes with your doctor.
  • See a specialist who deals with the symptoms that bother you most. For example, if you have rash, see a dermatologist (skin doctor).

What are the treatments for autoimmune diseases?

The treatment depends on the disease. In most cases, the goal of treatment is to suppress (slow down) your immune system, and ease swelling, redness, and pain from inflammation. Your doctor may give you corticosteroids or other medicines to help you feel better. For some diseases, you may need treatment for the rest of your life.


[Learn More in MedlinePlus]

Code History

  • FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
  • FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
  • FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018