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v1.0.0
ICD-10 Guide
DiagnosesSicca

Sicca

ICD-10 Coding for Sicca Syndrome(M35.0, H16.22)

PRIMARY SPECIALTYRheumatology
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Sicca?
Essential facts and insights about Sicca Syndrome

Key Clinical Considerations:

  • Dry eyes and dry mouth
  • Schirmer's test for tear production
  • Oral examination for dryness

Clinical Information

Clinical Criteria & Documentation Requirements

  • Patient history of symptoms
  • Results of diagnostic tests
  • Assessment of associated autoimmune conditions

Coding Guidelines

Usage Guidelines & Examples

  • Follow guidelines for coding Sicca syndrome versus other dry eye conditions.
  • Common errors include misclassifying the severity of symptoms.

Code Exclusions

Important Exclusions

  • Other causes of dry eyes (e.g., medication side effects)
  • Conditions like Sjögren's syndrome that may overlap

Related ICD-10 Codes

Primary Codes
M35.00
Sicca syndrome, unspecified
H04.123
Dry eye syndrome, bilateral
Differential Codes
H16.22
M35.0

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Rheumatology

Specialty Applications

  • Adults with autoimmune disorders
  • Rheumatology clinics and ophthalmology practices

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

What are the documentation requirements?

Document patient symptoms, test results, and any associated conditions.

What are the billing considerations?

Ensure accurate coding to reflect the severity and associated conditions for proper reimbursement.