2026 ICD-10-CM Diagnosis Code M35.03Sjogren syndrome with myopathy

ICD-10-CM Codes›M00–M99›M30-M36›M35

ICD-10-CM M35.03
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

M35.03 is a billable ICD-10-CM diagnosis code for sjogren syndrome with myopathy. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 545 through 547. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 113 closely related codes. Coders also document this condition as myopathy due to Sjögren's disease. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Myopathies and Systemic lupus erythematosus and connective tissue disorders.

M35.03 no longer risk-adjusts for Medicare Advantage: it mapped to HCC 40 under the retired CMS-HCC V24 model through payment year 2025 but maps to no category in the live V28 model. It still risk-adjusts in the PACE (CMS-HCC V22) category 40, ESRD (V21) category 40, ESRD (V21) category 75, ESRD (V24) category 40, and RxHCC Part D (V08) category 84 for payment year 2026.

Code Identity

ICD-10-CM Code
M35.03
Billable Status
Yes — Valid for Submission
Code Describes
Sjogren syndrome with myopathy
Short Description
Sjogren syndrome with myopathy
Same as the full description in the CMS dataset.
Parent Code
M35.0
Sjogren syndrome

Code Classification

ChapterM00–M99Diseases of the musculoskeletal system and connective tissue
SectionM30-M36Systemic connective tissue disorders
CategoryM35Other systemic involvement of connective tissue
This CodeM35.03Sjogren syndrome with myopathy

Medicare Risk Adjustment (HCC)Billing

M35.03 no longer risk-adjusts for Medicare Advantage: it maps to no payment category in the live CMS-HCC V28 model, although it still risk-adjusts in the other CMS models shown below.

CMS-HCC V28 (Medicare Advantage Payment Model)
Not mapped
Dropped in V28 see all codes that no longer risk-adjust
Prior Model (CMS-HCC V24)
HCC 40
V24 retired last contributed to a Medicare Advantage risk score in payment year 2025
Other CMS Models
PACE (CMS-HCC V22): HCC 40 · ESRD (V21): HCC 40 · ESRD (V21): HCC 75 · ESRD (V24): HCC 40
ESRD V21 weights: 0.072 dialysis, 0.274–0.398 functioning graft · ESRD V21 weights: 0.059 dialysis, 0.284–0.323 functioning graft · ESRD V24 weights: 0.058 dialysis, 0.284–0.414 functioning graft
Part D (RxHCC)
RxHCC 84 — Systemic Lupus Erythematosus and Other Systemic Connective Tissue Disorders
also risk-adjusts in the Part D prescription drug model (V08)

Source: CMS Payment Year 2026 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Myopathy due to Sjögren's disease

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR NVS018
Myopathies
Default principal diagnosis: inpatient No · outpatient No
CCSR MUS024
Systemic lupus erythematosus and connective tissue disorders
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Muscle Disorders

Your muscles help you move and help your body work. Different types of muscles have different jobs. There are many problems that can affect muscles. Muscle disorders can cause weakness, pain or even paralysis.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert M35.03 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
710.2 Sicca syndrome
ApproximateCombination The match is approximate, and more than one code can be needed to describe the source diagnosis. Confirm with contextual judgment.
ICD-9-CM
359.6 Infl myopathy in oth dis
ApproximateCombination The match is approximate, and more than one code can be needed to describe the source diagnosis. Confirm with contextual judgment.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2021No changes
FY 2022RevisedCode revised
FY 2023–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About M35.03Overview

What is the ICD-10 code for sjogren syndrome with myopathy?

The ICD-10-CM code for sjogren syndrome with myopathy is M35.03 (sometimes written as M3503). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

Is M35.03 (Sjogren syndrome) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report sjogren syndrome with myopathy on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does M35.03 group to?

When sjogren syndrome with myopathy is the principal diagnosis on an inpatient stay, it groups to MS-DRG 545, 546, 547, with relative weights from 0.8362 to 2.4817 depending on complications. Higher weights mean higher Medicare reimbursement.

Is M35.03 a CC or MCC?

CMS lists M35.03 as a CC (complication or comorbidity) for FY 2026. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 113 closely related codes in its exclusion list.

What is the ICD-9 equivalent of M35.03?

Under the General Equivalence Mappings, sjogren syndrome with myopathy converts to ICD-9-CM 710.2 (sicca syndrome) and 359.6 (infl myopathy in oth dis). The mapping is approximate, so confirm the match fits the documentation.

Does M35.03 risk-adjust for Medicare Advantage payment?

Not for Medicare Advantage. M35.03 mapped to HCC 40 in the retired CMS-HCC V24 model, which last determined payment in 2025, but it maps to no category in the live V28 model; see all codes that no longer risk-adjust. It still risk-adjusts in the PACE (CMS-HCC V22) category 40 (Rheumatoid Arthritis and Inflammatory Connective Tissue Disease), ESRD (V21) category 40 (Rheumatoid Arthritis and Inflammatory Connective Tissue Disease), ESRD (V21) category 75 (Polyneuropathy), ESRD (V24) category 40 (Rheumatoid Arthritis and Inflammatory Connective Tissue Disease), and RxHCC Part D (V08) category 84 (Systemic Lupus Erythematosus and Other Systemic Connective Tissue Disorders).