M05.59: Rheumatoid polyneuropathy with rheumatoid arthritis of multiple sites

Risk adjustment

M05.59 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

M05.59 is named in 52 Medicare coverage policies: 42 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