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D89.834 vs M35.9

D89.834 (Cytokine release syndrome, grade 4) compared with M35.9 (Systemic involvement of connective tissue, unspecified), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.

Can these codes be reported together?

No — do not report together. D89.834 carries an Excludes1 note covering M35.9: “autoimmune disease (systemic) NOS (M35.9)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Side by side

D89.834Cytokine release syndrome, grade 4M35.9Systemic involvement of connective tissue, unspecified
Billing statusBillableBillable
ClassificationD50-D89 — Diseases of the Blood and Blood-forming Organs and Certain Disorders Involving the Immune Mechanism (D50-D89)M00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)
DefinitionCytokine release syndrome, grade 4 is a billable ICD-10-CM diagnosis code (D89.834).Systemic involvement of connective tissue, unspecified is a billable ICD-10-CM diagnosis code (M35.9).
Includes
defects in the complement system
immunodeficiency disorders, except human immunodeficiency virus [HIV] disease
sarcoidosis
autoimmune disease NOS
collagen (vascular) disease NOS
systemic autoimmune disease
systemic collagen (vascular) disease
Use additional code
code for adverse effect, if applicable, to identify immune checkpoint inhibitors and immunostimulant drugs (T45.AX5)
code to identify associated manifestations
Code first
underlying cause, such as:
complications following infusion, transfusion and therapeutic injection (T80.89-)

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources