M05.3 — Rheumatoid heart disease with rheumatoid arthritis
M05.3 is a non-billable header ICD-10-CM code for rheumatoid heart disease with rheumatoid arthritis. It cannot be billed on its own: choose one of the more specific child codes below.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Rheumatoid carditis
- Rheumatoid endocarditis
- Rheumatoid myocarditis
- Rheumatoid pericarditis
Other codes that can never be billed with M05.3
These codes carry an Excludes1 note pointing at M05.3. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading M05.3 alone.
- G73.7Myopathy in diseases classified elsewhere
- I09.9Rheumatic heart disease, unspecified
- I32Pericarditis in diseases classified elsewhere
- I39Endocarditis and heart valve disorders in diseases classified elsewhere
- I41Myocarditis in diseases classified elsewhere
- I52Other heart disorders in diseases classified elsewhere
Risk adjustment
M05.3 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Code to one of these instead M05.3
9 child codes. Green means billable.
- M05.30Rheumatoid heart disease with rheumatoid arthritis of unspecified site
- M05.31Rheumatoid heart disease with rheumatoid arthritis of shoulder
- M05.32Rheumatoid heart disease with rheumatoid arthritis of elbow
- M05.33Rheumatoid heart disease with rheumatoid arthritis of wrist
- M05.34Rheumatoid heart disease with rheumatoid arthritis of hand
- M05.35Rheumatoid heart disease with rheumatoid arthritis of hip
- M05.36Rheumatoid heart disease with rheumatoid arthritis of knee
- M05.37Rheumatoid heart disease with rheumatoid arthritis of ankle and foot
- M05.39Rheumatoid heart disease with rheumatoid arthritis of multiple sites
Related codes at this level
Codes that share M05. If M05.3 is not quite right, the correct code is usually one of these.
- M05.0Felty's syndrome
- M05.1Rheumatoid lung disease with rheumatoid arthritis
- M05.2Rheumatoid vasculitis with rheumatoid arthritis
- M05.4Rheumatoid myopathy with rheumatoid arthritis
- M05.5Rheumatoid polyneuropathy with rheumatoid arthritis
- M05.6Rheumatoid arthritis with involvement of other organs and systems
- M05.7Rheumatoid arthritis with rheumatoid factor without organ or systems involvement
- M05.8Other rheumatoid arthritis with rheumatoid factor
- M05.9Rheumatoid arthritis with rheumatoid factor, unspecified
- M05.AAbnormal rheumatoid factor and anti-citrullinated protein antibody with rheumatoid arthritis
Questions about M05.3
- Is M05.3 a billable ICD-10-CM code?
- No. M05.3 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does M05.3 sit in the tabular list?
- Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Inflammatory polyarthropathies (M05-M14).