2026 ICD-10-CM Diagnosis Code M35.05Sjogren syndrome with inflammatory arthritis

ICD-10-CM Codes›M00–M99›M30-M36›M35

ICD-10-CM M35.05
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

M35.05 is a billable ICD-10-CM diagnosis code for sjogren syndrome with inflammatory arthritis. 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. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Other specified joint disorders and Systemic lupus erythematosus and connective tissue disorders.

M35.05 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 (V24) category 40, and RxHCC Part D (V08) category 84 for payment year 2026.

Code Identity

ICD-10-CM Code
M35.05
Billable Status
Yes — Valid for Submission
Code Describes
Sjogren syndrome with inflammatory arthritis
Short Description
Sjogren syndrome with inflammatory arthritis
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 CodeM35.05Sjogren syndrome with inflammatory arthritis

Medicare Risk Adjustment (HCC)Billing

M35.05 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 (V24): HCC 40
ESRD V21 weights: 0.072 dialysis, 0.274–0.398 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.

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 MUS007
Other specified joint disorders
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

Arthritis

If you feel pain and stiffness in your body or have trouble moving around, you might have arthritis. Any disorder that affects the joints is often called arthritis. Joints are places where two bones meet, such as your elbow or knee.

The full article covers:

  • What is arthritis?
  • What are the types of arthritis?
  • What are the symptoms of arthritis?
  • Who is more likely to get arthritis?
  • How is arthritis diagnosed?
  • What are the treatments for arthritis?

Read the full article at MedlinePlus

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

Code History & ChangesHistory

Replacement M35.05 replaces the following previously assigned code(s):

  • M35.09 - Sicca syndrome with other organ involvement
  • M35.09 - Sjogren syndrome with other organ involvement
FY 2022AddedAdded to the ICD-10-CM code setEffective October 1, 2021.
FY 2023–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About M35.05Overview

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

The ICD-10-CM code for sjogren syndrome with inflammatory arthritis is M35.05 (sometimes written as M3505). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

Is M35.05 (Sjogren syndrome) a billable code?

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

What MS-DRG does M35.05 group to?

When sjogren syndrome with inflammatory arthritis 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.

Does M35.05 risk-adjust for Medicare Advantage payment?

Not for Medicare Advantage. M35.05 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 (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).