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ICD-10 Guide
ICD-10 CodesM05.079

M05.079

Billable

Felty's syndrome, unspecified ankle and foot

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/12/2025

Code Description

ICD-10 M05.079 is a billable code used to indicate a diagnosis of felty's syndrome, unspecified ankle and foot.

Key Diagnostic Point:

Felty's syndrome is a rare complication of rheumatoid arthritis characterized by the triad of rheumatoid arthritis, splenomegaly, and neutropenia. In the context of the ankle and foot, patients may experience significant joint inflammation, pain, and deformity due to the underlying autoimmune process. Anatomically, the ankle joint comprises the tibia, fibula, and talus, while the foot consists of multiple bones including the metatarsals and phalanges. The inflammatory process can lead to synovitis, erosion of joint surfaces, and subsequent functional limitations. Clinically, patients may present with swelling, tenderness, and reduced range of motion in the affected joints, impacting their mobility and quality of life. The pathophysiology involves immune-mediated damage to the synovial membrane, leading to chronic inflammation and joint destruction.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of autoimmune processes and their musculoskeletal manifestations.
  • Involves multiple anatomical structures in the ankle and foot.
  • Differentiation from other forms of arthritis and related conditions.
  • Documentation of systemic involvement and potential complications.

Audit Risk Factors

  • Inadequate documentation of joint involvement and severity.
  • Failure to capture systemic symptoms associated with Felty's syndrome.
  • Misclassification of the condition due to overlapping symptoms with other arthritides.
  • Lack of clear linkage between diagnosis and treatment provided.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Orthopedic documentation should include imaging studies (X-rays, MRIs) to assess joint damage, functional assessments to evaluate mobility, and detailed notes on joint examination findings.

Common Clinical Scenarios

Patients may require surgical intervention for joint deformities or severe pain management, including arthroplasty or joint fusion.

Billing Considerations

Orthopedic considerations include the assessment of joint stability and the potential need for reconstructive surgery.

Rheumatology

Documentation Requirements

Rheumatologic documentation must include laboratory tests for inflammatory markers (e.g., ESR, CRP), neutrophil counts, and assessments of disease activity (e.g., DAS28).

Common Clinical Scenarios

Management of Felty's syndrome may involve immunosuppressive therapy and monitoring for complications such as infections due to neutropenia.

Billing Considerations

Systemic involvement, including splenomegaly and its effects on blood counts, must be documented.

Physical Medicine

Documentation Requirements

Functional assessments should evaluate the patient's ability to perform daily activities and the need for assistive devices.

Common Clinical Scenarios

Rehabilitation may focus on restoring mobility and strength, with tailored exercise programs.

Billing Considerations

Documentation should address mobility limitations and the impact on the patient's quality of life.

Coding Guidelines

Inclusion Criteria

Use M05.079 When
  • Follow official coding guidelines for laterality (if applicable), severity of the condition, and the type of encounter (initial, follow
  • up, etc
  • Ensure that all relevant clinical information is documented to support the diagnosis

Exclusion Criteria

Do NOT use M05.079 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99214CPT Code

Established patient office visit, level 4

Clinical Scenario

Used for follow-up visits for management of Felty's syndrome.

Documentation Requirements

Documentation must include history, examination findings, and treatment plan.

Specialty Considerations

Rheumatology considerations include monitoring disease activity and adjusting treatment.

20610CPT Code

Arthrocentesis, aspiration and/or injection into a major joint or bursa

Clinical Scenario

Used for joint injections in patients with severe inflammation.

Documentation Requirements

Indicate the joint involved and the reason for the procedure.

Specialty Considerations

Orthopedic considerations include assessing joint effusion.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding musculoskeletal conditions, including Felty's syndrome, which can help in better tracking and management of the disease.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding musculoskeletal conditions, including Felty's syndrome, which can help in better tracking and management of the disease.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding musculoskeletal conditions, including Felty's syndrome, which can help in better tracking and management of the disease.

Resources

Clinical References

  • •
    American College of Rheumatology Guidelines

Coding & Billing References

  • •
    American College of Rheumatology Guidelines

Frequently Asked Questions

What are the common symptoms of Felty's syndrome?

Common symptoms include joint pain and swelling, recurrent infections due to neutropenia, and splenomegaly. Patients may also experience fatigue and systemic symptoms related to rheumatoid arthritis.