M35.0B: Sjogren syndrome with vasculitis
M35.0B, sjogren syndrome with vasculitis, is listed as a covered diagnosis in 5 Medicare billing and coding articles that apply to 10 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 M35.0B 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 | — | 2 |
| Q5123 | Injection, rituximab-arrx, biosimilar, (riabni), 10 mg | Carrier judgment | — | 2 |
| Q5119 | Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg | Carrier judgment | — | 2 |
| Q5115 | Injection, rituximab-abbs, biosimilar, (truxima), 10 mg | Special coverage instructions apply | — | 2 |
| 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 |
| G0127 | Trimming of dystrophic nails, any number | Special coverage instructions apply | — | 1 |
| J9311 | Injection, rituximab 10 mg and hyaluronidase | Special coverage instructions apply | — | 1 |
| J3590 | Unclassified biologics | Carrier judgment | — | 1 |
| G0255 | Current perception threshold/sensory nerve conduction test, (snct) per limb, any nerve | Non-covered by Medicare | Not covered | 2 |
Medicare policy articles listing M35.0B
- A55639: Billing and Coding: Chemotherapy Agents for Non-Oncologic Conditions (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 6 Level II codes)
- A57954: Billing and Coding: Routine Foot Care (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33941, L35138, L37643
- A56380: Billing and Coding: Rituximab (Palmetto GBA (MAC - Part A, MAC - Part B); 6 Level II codes). LCD with the same title: L35026
- A57478: Billing and Coding: Nerve Conduction Studies and Electromyography (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
- A57668: Billing and Coding: Nerve Conduction Studies and Electromyography (Wellpoint Federal (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
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 M35 diagnoses (Other systemic involvement of connective tissue)
- M35.02 — Sjogren syndrome with lung involvement
- M35.03 — Sjogren syndrome with myopathy
- M35.04 — Sjogren syndrome with tubulo-interstitial nephropathy
- M35.05 — Sjogren syndrome with inflammatory arthritis
- M35.06 — Sjogren syndrome with peripheral nervous system involvement
- M35.07 — Sjogren syndrome with central nervous system involvement
- M35.08 — Sjogren syndrome with gastrointestinal involvement
- M35.09 — Sjogren syndrome with other organ involvement
- M35.0A — Sjogren syndrome with glomerular disease
- M35.2 — Behcet's disease
- M35.3 — Polymyalgia rheumatica
- M35.4 — Diffuse (eosinophilic) fasciitis
- M35.7 — Hypermobility syndrome
- M35.81 — Multisystem inflammatory syndrome
- M35.89 — Other specified systemic involvement of connective tissue
Frequently asked questions
Does Medicare cover M35.0B (Sjogren syndrome with vasculitis)?
Medicare covers items and services, not diagnoses. 5 Medicare billing and coding articles list M35.0B as a covered diagnosis for 10 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 M35.0B?
The Level II codes from the policies most specific to this diagnosis are J9312 (Injection, rituximab, 10 mg, 2 articles); Q5123 (Injection, rituximab-arrx, biosimilar, (riabni), 10 mg, 2 articles); Q5119 (Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg, 2 articles); Q5115 (Injection, rituximab-abbs, biosimilar, (truxima), 10 mg, 2 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 M35.0B?
A55639 (Billing and Coding: Chemotherapy Agents for Non-Oncologic Conditions); A57954 (Billing and Coding: Routine Foot Care); A56380 (Billing and Coding: Rituximab), and 2 more articles.
What is ICD-10-CM code M35.0B?
M35.0B is the ICD-10-CM code for sjogren syndrome with vasculitis, in category M35 (Other systemic involvement of connective tissue), 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