Inflammatory polyarthropathies

Historical Changes

• •FY 2025: Routine maintenance updates with minor terminology clarifications
• •FY 2024: Enhanced specificity requirements for certain code ranges
• •FY 2023: Updated documentation guidelines for improved clarity

Upcoming Changes

• •Proposed updates pending review by Coordination and Maintenance Committee
• •Under consideration: Enhanced digital health integration codes

Implementation Guidance

• •Review all FY 2026 updates for M04-M14 codes before implementation
• •Always verify the most current codes in the ICD-10-CM manual
• •Ensure clinical documentation supports the selected diagnosis codes
• +3 more guidance items...

Key Usage Points:

• •M04-M14 codes are used for patients with confirmed diagnoses of inflammatory polyarthropathies.
• •The codes specify the type of polyarthropathy, the affected joints, and the disease's activity level.
• •M04-M14 codes are not used for patients with suspected but not confirmed polyarthropathies.
• •The codes must be supported by appropriate clinical documentation.
• •M04-M14 codes should be updated if the disease's activity level changes.

When to Use:

• ✓When a patient has a confirmed diagnosis of an inflammatory polyarthropathy.
• ✓When the patient's condition has changed, such as a change in the disease's activity level.
• ✓When a patient has multiple affected joints.
• ✓When a patient has a specific type of polyarthropathy, such as rheumatoid arthritis or gout.

When NOT to Use:

• ✗When a patient has a suspected but not confirmed polyarthropathy.
• ✗When a patient has a non-inflammatory joint disease.
• ✗When a patient has a single affected joint.
• ✗When a patient has a condition that is better represented by another code.

Common Documentation Errors:

• ⚠Not specifying the type of polyarthropathy
• ⚠Not specifying the affected joints
• ⚠Not specifying the disease activity level
• ⚠Not including supporting evidence