M05.4
M05.4 — Rheumatoid myopathy with rheumatoid arthritis
Non-billable headerICD-10-CM
M05.4 is a non-billable header ICD-10-CM code for rheumatoid myopathy with rheumatoid arthritis. It cannot be billed on its own: choose one of the more specific child codes below.
Risk adjustment
M05.4 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 M05.4
9 child codes. Green means billable.
- M05.40Rheumatoid myopathy with rheumatoid arthritis of unspecified site
- M05.41Rheumatoid myopathy with rheumatoid arthritis of shoulder
- M05.42Rheumatoid myopathy with rheumatoid arthritis of elbow
- M05.43Rheumatoid myopathy with rheumatoid arthritis of wrist
- M05.44Rheumatoid myopathy with rheumatoid arthritis of hand
- M05.45Rheumatoid myopathy with rheumatoid arthritis of hip
- M05.46Rheumatoid myopathy with rheumatoid arthritis of knee
- M05.47Rheumatoid myopathy with rheumatoid arthritis of ankle and foot
- M05.49Rheumatoid myopathy with rheumatoid arthritis of multiple sites
Related codes at this level
Codes that share M05. If M05.4 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
- M05.3Rheumatoid heart disease 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 M05.4
- Is M05.4 a billable ICD-10-CM code?
- No. M05.4 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does M05.4 sit in the tabular list?
- Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Inflammatory polyarthropathies (M05-M14).