Rheumatoid Arthritis ICD 10 Code

Refresher: What are ICD-10 codes?

ICD-10, also known as the International Classification of Diseases – 10th edition, is commonly used to identify different categories and types of diseases or injuries. It is a seven-character, alphanumeric code which consists of a letter at the start followed by two numbers.[1]

The classification is achieved through the first letter, which typically denotes the broader range within which the disease is classified. The WHO has divided all of the known diseases into ranges that consist of letters A through Z.[2] A further breakdown is achieved through numbers and letters, which denote subcategories in the following manner.

“A01 – {Disease}

A01.0 {Disease] of the lungs

A01.01 … simple

A01.02 … complex

A01.020 … affecting the trachea

A01.021 … affecting the cardiopulmonary system

A01.021A … initial encounter

A01.021D … subsequent encounter

A01.021S … sequela [1]”

This classification can also be understood through some common conventions that consist of the following;

• Brackets [ ]
• Parentheses ( )
• “Not Elsewhere Classified”
• “Not Otherwise Specified”
• “Includes”
• “Excludes” (this can vary between soft and hard excludes where the former is a part of the condition but not mentioned in that code and the latter is completely excluded from the code, not to be mentioned within it)
• Others [1]

The ICD-10 categorization and classification are essential for medical and billing companies along with patients. This is because these codes are usually used by insurance or medical billing companies when they need to evaluate the benefits of a treatment plan and whether they outweigh the costs.

While this classification was first introduced to the world by WHO, it has since been adopted by many countries, one of which is the USA. Here, a clinical modification of the ICD exists, known as the ICD-10-CM. This has been broken down into many different levels over the years to make the classification, identification, and monitoring of illness much easier.[3]

What is the ICD 10 Code for Rheumatoid Arthritis?

According to the WHO, the ICD-10 code for rheumatoid arthritis with rheumatoid factor is M05, while the code for other rheumatoid arthritis is M06. Different subcategories have different ICD codes, and they vary according to the cause, location, and nature of the arthritis. This is discussed in the table below;

Rheumatoid Arthritis ICD 10 code: M05, M06

Rheumatoid Arthritis ICD code M05, M06 Lookup

Below is a table of the ICD 10 rheumatoid arthritis codes for rheumatoid arthritis, which is classified under M06 and M06, namely “rheumatoid arthritis with rheumatoid factor” and “Other rheumatoid arthritis,” respectively[4][5].

M05: Rheumatoid Arthritis with Rheumatoid Factor

Types of Rheumatoid Arthritis Coded Under M05, M06

M05 and M06 are a broader categorization of rheumatoid arthritis. However, they do not specify the subtype of the disease. The M05 and M06 codes can be used to explore further subcategories. Here are some types classified under M05;

• Felty’s syndrome
• Rheumatoid vasculitis with rheumatoid arthritis
• Rheumatoid heart disease with rheumatoid arthritis
• Rheumatoid myopathy with rheumatoid arthritis
• Rheumatoid polyneuropathy with rheumatoid arthritis
• Rheumatoid arthritis with involvement of other organs and systems
• Rheumatoid arthritis with rheumatoid factor without organ or systems involvement
• Other rheumatoid arthritis with rheumatoid factor
• Rheumatoid arthritis with rheumatoid factor, unspecified

Some types classified under M06 include;

• Rheumatoid arthritis without rheumatoid factor
• Rheumatoid bursitis
• Rheumatoid nodule
• Inflammatory polyarthropathy
• Other specified rheumatoid arthritis
• Rheumatoid arthritis, unspecified

Since rheumatoid arthritis can have many different causes and could originate in different parts of the body, it is essential to understand the different ICD-10 codes that can lead to quicker identification. Since causes and location can drastically change ICD-10 codes, an understanding of the same is essential.

Rheumatoid Arthritis Excluded From M05

Rheumatoid arthritis with rheumatoid factor M05 excludes the following;

• Rheumatic fever (I00)
• Juvenile rheumatoid arthritis (M08)
• Rheumatoid arthritis of spine (M45)

Conclusion

ICD-10 codes are extremely helpful when it comes to the assistance patients, and providers need in the navigation of a treatment plan, from diagnosis to the final procedures. Medical billing companies are an easy hurdle to encounter if the process has been accurately classified and treated parallel to the ICD-10 classification.

Some forms of rheumatoid arthritis may be more severe than others. Following ICD-10 codes can lead to a better treatment plan and an easier process in the long run.