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M36.1 ICD-10-CM Code: Arthropathy in neoplastic disease

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
4 inclusion terms · 1 Excludes1 · 1 Excludes2 · 4 code-first instructions

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.

  • MS-DRG 553 — BONE DISEASES AND ARTHROPATHIES WITH MCC (MDC 08)
  • MS-DRG 554 — BONE DISEASES AND ARTHROPATHIES WITHOUT MCC (MDC 08)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for M36.1 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on M36.1 itself; “inherited from” names the category or block whose note applies here.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • autoimmune disease NOS
  • collagen (vascular) disease NOS
  • systemic autoimmune disease
  • systemic collagen (vascular) disease

Source: inherited from M30-M36

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

  • autoimmune disease, single organ or single cell-type -code to relevant condition category

Source: inherited from M30-M36

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Source: inherited from M36

Code First

Underlying conditions that must be sequenced before this code.

  • underlying neoplasm, such as:
  • leukemia (C91-C95)
  • malignant histiocytosis (C96.A)
  • multiple myeloma (C90.0)

Coder workflow for M36.1

MedCoder structured workflow — derived from this code’s own official record

Before you code M36.1

  1. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with M36.1. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support a condition named in M36.1’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.
  2. Is the underlying (etiologic) condition the Code First note names documented?
    Yes → Sequence the underlying condition first, then M36.1.
    No → Continue; do not add an underlying condition the record does not document.

    ReviewC96.A, C90.0

Consider M36.1. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
The underlying (etiologic) condition
Named in the Code First note; sequenced before this code when documented (Guidelines I.A.13).

Official instructions as workflow

  • Excludes1 — check before selecting M36.1(1 note)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with M36.1: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    See the official tabular notes · Guidelines I.A.12.a

  • Excludes2 — not part of M36.1(1 note)

    Coding workflow: The conditions named in this note are not included in M36.1. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareM14

    See the official tabular notes · Guidelines I.A.12.b

  • Code First — sequencing check(4 notes)

    Coding workflow: Check whether the underlying or etiologic condition the note names is documented. When it is, sequence it before M36.1. Do not add an underlying condition the record does not document.

    ReviewC96.A, C90.0

    See the official tabular notes · Guidelines I.A.13

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition M36.1 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

Documentation: The underlying condition the Code First note names is documented alongside this condition.

Coding question: How are the two sequenced?

Path: Review the Code First note.

Reason: The underlying condition is sequenced first and the manifestation follows (Guidelines I.A.13).

ReviewC96.A, C90.0

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Code Overview

Arthropathy in neoplastic disease is a billable ICD-10-CM diagnosis code (M36.1).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Decision Points

The directives on this code's own record, as a pre-claim checklist.

  1. Sequencing: 4 Code First instructions — the underlying condition is sequenced before this code when present. See the Code First notes
  2. 1 Excludes1 entry — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
  3. 1 Excludes2 entry — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

Verify Before Coding

  • Principal-diagnosis restriction. This is a manifestation code: the Medicare Code Editor requires the underlying condition (etiology) to be sequenced first, with this code reported after it.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name M36.1 or its code family, from the CMS ICD-10-CM tabular instructional notes and the CMS ICD-10-CM Index to Diseases and Injuries. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 2 Excludes1 notes across 2 chapters: L94 — Other localized connective tissue disorders (via M36.-), M14 — Arthropathies in other diseases classified elsewhere.

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 2 Excludes2 notes across 2 chapters: I77 — Other disorders of arteries and arterioles (via M36.-), J82 — Pulmonary eosinophilia, not elsewhere classified (via M36.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Referenced by 1 Code First instruction: J84.170 — Interstitial lung disease with progressive fibrotic phenotype in diseases classified elsewhere (via M36.-).

Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.

Referenced by 1 Index etiology/manifestation pair: D49.9 — Neoplasm of unspecified behavior of unspecified site.

The ICD-10-CM Index lists these etiology codes with this code in brackets — the manifestation, reported second.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 2 MS-DRGs: DRG 553 (MDC 08), DRG 554 (MDC 08).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):MUS007 — Other specified joint disorders; NEO074 — Conditions due to neoplasm or the treatment of neoplasm.

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Principal diagnosis restriction (Medicare Code Editor)

Manifestation code — the underlying condition is sequenced first.

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical categories (Other specified joint disorders, Conditions due to neoplasm or the treatment of neoplasm).

H47.42 — Disorders of optic chiasm in (due to) neoplasm, H47.521 — Disorders of visual pathways in (due to) neoplasm, right side, H47.522 — Disorders of visual pathways in (due to) neoplasm, left side, H47.529 — Disorders of visual pathways in (due to) neoplasm, unspecified side, H47.631 — Disorders of visual cortex in (due to) neoplasm, right side of brain, H47.632 — Disorders of visual cortex in (due to) neoplasm, left side of brain, H47.639 — Disorders of visual cortex in (due to) neoplasm, unspecified side of brain, J91.0 — Malignant pleural effusion, K12.31 — Oral mucositis (ulcerative) due to antineoplastic therapy, M36.0 — Dermato(poly)myositis in neoplastic disease, M84.50XA — Pathological fracture in neoplastic disease, unspecified site, initial encounter for fracture, M84.511A — Pathological fracture in neoplastic disease, right shoulder, initial encounter for fracture, M84.512A — Pathological fracture in neoplastic disease, left shoulder, initial encounter for fracture, M84.519A — Pathological fracture in neoplastic disease, unspecified shoulder, initial encounter for fracture, M84.521A — Pathological fracture in neoplastic disease, right humerus, initial encounter for fracture, M84.522A — Pathological fracture in neoplastic disease, left humerus, initial encounter for fracture, M84.529A — Pathological fracture in neoplastic disease, unspecified humerus, initial encounter for fracture, M84.531A — Pathological fracture in neoplastic disease, right ulna, initial encounter for fracture, M84.532A — Pathological fracture in neoplastic disease, left ulna, initial encounter for fracture, M84.533A — Pathological fracture in neoplastic disease, right radius, initial encounter for fracture, +777 more

Contextual Map

Every relationship of M36.1 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run M36.1 with these 12 related codes in Claim Check

Hierarchy

Code First

Referenced by Excludes1 notes

Referenced by Excludes2 notes

Referenced by Code First instructions

Referenced by Index etiology/manifestation pairs

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • MDC 08 — Diseases and Disorders of the Musculoskeletal System and Connective Tissue[MDC crossing]: “Diseases and Disorders of the Musculoskeletal System and Connective Tissue — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 18,508 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Nearest codes

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "M36.1 — Arthropathy in neoplastic disease." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/m36.1-arthropathy-in-neoplastic-disease

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Arthropathy in neoplastic disease

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to M36.1 in its code family, with their registry titles.

View all codes in the M36 family