M12.3
M12.3 — Palindromic rheumatism
Non-billable headerICD-10-CM
M12.3 is a non-billable header ICD-10-CM code for palindromic rheumatism. It cannot be billed on its own: choose one of the more specific child codes below.
Other codes that can never be billed with M12.3
These codes carry an Excludes1 note pointing at M12.3. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading M12.3 alone.
Risk adjustment
M12.3 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 M12.3
10 child codes. Green means billable.
- M12.30Palindromic rheumatism, unspecified site
- M12.31Palindromic rheumatism, shoulder
- M12.32Palindromic rheumatism, elbow
- M12.33Palindromic rheumatism, wrist
- M12.34Palindromic rheumatism, hand
- M12.35Palindromic rheumatism, hip
- M12.36Palindromic rheumatism, knee
- M12.37Palindromic rheumatism, ankle and foot
- M12.38Palindromic rheumatism, other specified site
- M12.39Palindromic rheumatism, multiple sites
Related codes at this level
Codes that share M12. If M12.3 is not quite right, the correct code is usually one of these.
Questions about M12.3
- Is M12.3 a billable ICD-10-CM code?
- No. M12.3 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does M12.3 sit in the tabular list?
- Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Inflammatory polyarthropathies (M05-M14).