M05.40 — Rheumatoid myopathy with rheumatoid arthritis of unspecified site
M05.40 is a billable, specific ICD-10-CM code for rheumatoid myopathy with rheumatoid arthritis of unspecified site. It is valid for submission on a claim.
Risk adjustment
M05.40 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 93 Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders0.617 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
M05.40 is named in 18 Medicare coverage policies — 12 listing it as supporting medical necessity, and 6 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A58865Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A58893Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A59374Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A59434Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
How M05.40 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to M05.40.
- Rheumatoid›myopathy
Related codes at this level
Codes that share M05.4. If M05.40 is not quite right, the correct code is usually one of these.
- 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
Questions about M05.40
- Is M05.40 a billable ICD-10-CM code?
- Yes. M05.40 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does M05.40 sit in the tabular list?
- Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Inflammatory polyarthropathies (M05-M14).