M31.31: Wegener's granulomatosis with renal involvement
M31.31, Wegener's granulomatosis with renal involvement, is listed as a covered diagnosis in 6 Medicare billing and coding articles that apply to 33 HCPCS Level II codes, including J9312 (Injection, rituximab, 10 mg), Q5123 (Injection, rituximab-arrx, biosimilar, (riabni), 10 mg), Q5119 (Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg). The articles come from 4 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with M31.31 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| J9312 | Injection, rituximab, 10 mg | Special coverage instructions apply | — | 3 |
| Q5123 | Injection, rituximab-arrx, biosimilar, (riabni), 10 mg | Carrier judgment | — | 3 |
| Q5119 | Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg | Carrier judgment | — | 3 |
| Q5115 | Injection, rituximab-abbs, biosimilar, (truxima), 10 mg | Special coverage instructions apply | — | 3 |
| J9260 | Injection, methotrexate sodium, 50 mg | Special coverage instructions apply | — | 1 |
| J9215 | Injection, interferon, alfa-n3, (human leukocyte derived), 250,000 iu | Special coverage instructions apply | — | 1 |
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg | Special coverage instructions apply | — | 1 |
| Q5104 | Injection, infliximab-abda, biosimilar, (renflexis), 10 mg | Special coverage instructions apply | — | 1 |
| Q5103 | Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg | Special coverage instructions apply | — | 1 |
| Q5121 | Injection, infliximab-axxq, biosimilar, (avsola), 10 mg | Carrier judgment | — | 1 |
| J9311 | Injection, rituximab 10 mg and hyaluronidase | Special coverage instructions apply | — | 1 |
| J3590 | Unclassified biologics | Carrier judgment | — | 1 |
| J1575 | Injection, immune globulin/hyaluronidase, (hyqvia), 100 mg immuneglobulin | Carrier judgment | — | 1 |
| J1569 | Injection, immune globulin, (gammagard liquid/gammagard liquid erc), 500 mg | Special coverage instructions apply | — | 1 |
| J1561 | Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg | Special coverage instructions apply | — | 1 |
| J1459 | Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mg | Carrier judgment | — | 1 |
| J1557 | Injection, immune globulin, (gammaplex), intravenous, non-lyophilized (e.g., liquid), 500 mg | Carrier judgment | — | 1 |
| J1556 | Injection, immune globulin (bivigam), 500 mg | Carrier judgment | — | 1 |
| J1568 | Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg | Carrier judgment | — | 1 |
| J1566 | Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mg | Special coverage instructions apply | — | 1 |
| J1554 | Injection, immune globulin (asceniv), 500 mg | Carrier judgment | — | 1 |
| J1599 | Injection, immune globulin, intravenous, non-lyophilized (e.g., liquid), not otherwise specified, 500 mg | Carrier judgment | — | 1 |
| J1572 | Injection, immune globulin, (flebogamma/flebogamma dif), intravenous, non-lyophilized (e.g., liquid), 500 mg | Special coverage instructions apply | — | 1 |
| J1460 | Injection, gamma globulin, intramuscular, 1 cc | Special coverage instructions apply | — | 1 |
| J1670 | Injection, tetanus immune globulin, human, up to 250 units | Special coverage instructions apply | — | 1 |
8 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing M31.31
- A55639: Billing and Coding: Chemotherapy Agents for Non-Oncologic Conditions (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 6 Level II codes)
- A52423: Billing and Coding: Infliximab and biosimilars (Wellpoint Federal (MAC - Part A, MAC - Part B); 4 Level II codes)
- A56380: Billing and Coding: Rituximab (Palmetto GBA (MAC - Part A, MAC - Part B); 6 Level II codes). LCD with the same title: L35026
- A59101: Billing and Coding: Off-label Use of Rituximab and Rituximab Biosimilars (Wellpoint Federal (MAC - Part A, MAC - Part B); 4 Level II codes). LCD with the same title: L38920, L39297
- A57554: Billing and Coding: Immune Globulins (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 20 Level II codes). LCD with the same title: L34771
- A57056: Billing and Coding: Aortography and Peripheral Angiography (First Coast Service Options, Inc. (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L36767
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other M31 diagnoses (Other necrotizing vasculopathies)
- M31.30 — Wegener's granulomatosis without renal involvement
- M31.11 — Hematopoietic stem cell transplantation-associated thrombotic…
- M31.19 — Other thrombotic microangiopathy
- M31.4 — Aortic arch syndrome [Takayasu]
- M31.5 — Giant cell arteritis with polymyalgia rheumatica
- M31.6 — Other giant cell arteritis
- M31.7 — Microscopic polyangiitis
Frequently asked questions
Does Medicare cover M31.31 (Wegener's granulomatosis with renal involvement)?
Medicare covers items and services, not diagnoses. 6 Medicare billing and coding articles list M31.31 as a covered diagnosis for 33 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 M31.31?
The Level II codes from the policies most specific to this diagnosis are J9312 (Injection, rituximab, 10 mg, 3 articles); Q5123 (Injection, rituximab-arrx, biosimilar, (riabni), 10 mg, 3 articles); Q5119 (Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg, 3 articles); Q5115 (Injection, rituximab-abbs, biosimilar, (truxima), 10 mg, 3 articles); J9260 (Injection, methotrexate sodium, 50 mg, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list M31.31?
A55639 (Billing and Coding: Chemotherapy Agents for Non-Oncologic Conditions); A52423 (Billing and Coding: Infliximab and biosimilars); A56380 (Billing and Coding: Rituximab), and 3 more articles.
What is ICD-10-CM code M31.31?
M31.31 is the ICD-10-CM code for Wegener's granulomatosis with renal involvement, in category M31 (Other necrotizing vasculopathies), chapter 13: Diseases of the musculoskeletal system and connective tissue.
Next steps
- Run a reimbursement report for a device billed under J9312
- Watch J9312 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9312
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 13: Diseases of the musculoskeletal system and connective tissue · All diagnoses · HCPCS lookup