2026 ICD-10-CM Diagnosis Code M36.4Arthropathy in hypersensitivity reactions classified elsewhere
ICD-10-CM Codes›M00–M99›M30-M36›M36
- Billable — Valid for Submission
- Not Chronic
M36.4 is a billable ICD-10-CM diagnosis code for arthropathy in hypersensitivity reactions classified elsewhere. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 553 through 554. The code is a manifestation code that cannot be reported as the principal diagnosis. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Allergic reactions and Other specified joint disorders.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for M36.4.
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Code First
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists, there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Joint Disorders
Your joints are places where two or more bones come together. Your shoulders, elbows, hips, knees, and knuckles are all joints. Your spine has joints, too.
The full article covers:
- What are joints?
- What are joint disorders?
- What diseases can affect the joints?
- What types of joint disorders happen from sudden injuries?
- What types of joint disorders happen from overuse?
- How can I keep my joints healthy?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert M36.4 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About M36.4Overview
Is M36.4 a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report arthropathy in hypersensitivity reactions classified elsewhere on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does M36.4 group to?
On inpatient claims, arthropathy in hypersensitivity reactions classified elsewhere maps to MS-DRG 553, 554, with relative weights from 0.8301 to 1.2963 depending on complications. Higher weights mean higher Medicare reimbursement.
Can M36.4 be a principal diagnosis?
No. This is a manifestation code: arthropathy in hypersensitivity reactions classified elsewhere describes the manifestation of an underlying disease rather than the disease itself, so the underlying condition is sequenced first.
What is the ICD-9 equivalent of M36.4?
Under the General Equivalence Mappings, arthropathy in hypersensitivity reactions classified elsewhere converts to ICD-9-CM 713.6 (arthrop w hypersen react). The mapping is approximate, so confirm the match fits the documentation.
Footnotes
[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.
