M05.519: Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified shoulder
M05.519 is a billable, specific ICD-10-CM code for rheumatoid polyneuropathy with rheumatoid arthritis of unspecified shoulder. It is valid for submission on a claim.
Check M05.519 with the rest of the claim: free scrubberOther codes that can never be billed with M05.519
Their own Excludes1 notes name this code, so the conflict is not listed above.
- R76.81Abnormal rheumatoid factor and anti-citrullinated protein antibody without rheumatoid arthritis
Risk adjustment
M05.519 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
M05.519 is named in 18 Medicare coverage policies: 8 listing it as supporting medical necessity, and 10 listing it as NOT covered. Which one applies depends on your Medicare contractor.
- A56731Billing and Coding: Nerve Blocks and Electrostimulation for Peripheral Neuropathynot covered
- A57589Billing and Coding: Nerve Blocks for Peripheral Neuropathynot covered
- A57663Billing and Coding: Nerve Blocks for Peripheral Neuropathynot covered
- A58865Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
Code history
Unchanged in every release from FY2024 to FY2027.