Tuesday, November 3, 2015

New ICD-10 RA Diagnosis Codes

How does ICD-10 affect rheumatology patients and their doctors?
Rheumatoid arthritis (RA) was previously represented by the ICD-9-CM code 714.0. Now RA and its many manifestations are represented by more than 300 individual codes that are grouped under two main categories: Rheumatoid arthritis with rheumatoid factor (ICD-10-CM code M05), and Other rheumatoid arthritis (ICD-10-CM code M06).

The increased number of codes allows for greater detail in documenting the specific manifestations of RA-related disease activity, such as identifying that the left shoulder joint is affected, or that a patient has rheumatoid lung involvement, or whether a patient tested positive for rheumatoid factor.

In my own case of RA, my 714.0 Rheumatoid Arthritis diagnosis has now been changed to “M06.09 Rheumatoid arthritis without rheumatoid factor of multiple sites.”

Examples of other ICD-10-CM codes related to RA disease manifestations:

M05.10 – Rheumatoid lung disease with rheumatoid arthritis of unspecified site
M05.352 – Rheumatoid heart disease with rheumatoid arthritis of left hip
M05.419 – Rheumatoid myopathy with rheumatoid arthritis of unspecified shoulder
M05.719 – Rheumatoid arthritis with rheumatoid factor of unspecified shoulder without organ or systems involvement
M06.071 – Rheumatoid arthritis without rheumatoid factor of right ankle and foot
M06.239 – Rheumatoid bursitis of unspecified wrist
M06.331 – Rheumatoid nodule of right wrist
M71.20 – Synovial cyst of popliteal space [Baker] of unspecified knee

I’m not sure what code would apply if you had seronegative negative RA with rheumatoid lung involvement as the code for rheumatoid lung disease with rheumatoid arthritis is M05.1 which falls under the classification of M05 which is Rheumatoid arthritis with rheumatoid factor.

With all of this in mind, no wonder my soon-to-be-retired rheumatologist said that if she had known exactly when all of this was coming, she might have retired a month sooner.

What do you think? Would having this greater amount of detail hiding in the numbers lead to improved quality of care?


Read this post in its entirety:
What's Your New RA Code?

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