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ICD-10 Guide
ICD-10 CodesM05.432

M05.432

Billable

Rheumatoid myopathy with rheumatoid arthritis of left wrist

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

Code Description

ICD-10 M05.432 is a billable code used to indicate a diagnosis of rheumatoid myopathy with rheumatoid arthritis of left wrist.

Key Diagnostic Point:

Rheumatoid myopathy is a condition characterized by muscle weakness and pain associated with rheumatoid arthritis (RA), an autoimmune disorder that primarily affects the joints. In this case, the left wrist is specifically involved, indicating localized joint inflammation and potential muscle involvement. The wrist consists of eight carpal bones, which articulate with the radius and ulna, allowing for a wide range of motion. In RA, synovial inflammation leads to joint damage, which can extend to surrounding muscles, resulting in myopathy. Clinically, patients may present with weakness in wrist flexion and extension, pain during movement, and swelling. The pathophysiology involves immune-mediated damage to both the synovial membrane and muscle fibers, leading to functional impairments and decreased quality of life.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Involvement of multiple anatomical structures (muscle and joint)
  • Need for precise documentation of laterality and severity
  • Differentiation from other types of myopathy or arthritis
  • Potential for systemic involvement affecting coding

Audit Risk Factors

  • Inadequate documentation of muscle involvement
  • Failure to specify laterality (left wrist)
  • Misclassification of rheumatoid myopathy as another type of myopathy
  • Lack of evidence for disease activity or severity

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Orthopedic documentation should include imaging studies (X-rays, MRIs) to assess joint damage, functional assessments to evaluate range of motion, and detailed notes on surgical considerations if applicable.

Common Clinical Scenarios

Common scenarios include surgical interventions for joint repair or replacement, as well as conservative management strategies.

Billing Considerations

Joint-specific considerations include the degree of synovitis, erosive changes, and the impact on surrounding structures.

Rheumatology

Documentation Requirements

Rheumatologic documentation must include laboratory tests for inflammatory markers (e.g., ESR, CRP), disease activity scores, and assessments of systemic involvement.

Common Clinical Scenarios

Scenarios often involve managing systemic symptoms and adjusting DMARD therapy based on disease progression.

Billing Considerations

Considerations include monitoring for extra-articular manifestations and the impact of comorbidities.

Physical Medicine

Documentation Requirements

Functional assessments should evaluate mobility, strength, and the need for assistive devices, along with rehabilitation goals.

Common Clinical Scenarios

Rehabilitation scenarios may include physical therapy for strength restoration and pain management.

Billing Considerations

Mobility limitations and the need for adaptive equipment should be documented to support treatment plans.

Coding Guidelines

Inclusion Criteria

Use M05.432 When
  • 10 coding guidelines require specificity in laterality (left wrist) and severity of the condition
  • Documentation must reflect the encounter type (initial, follow
  • up) and any relevant comorbidities

Exclusion Criteria

Do NOT use M05.432 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

97110CPT Code

Therapeutic exercises

Clinical Scenario

Used in rehabilitation to improve strength and range of motion in the affected wrist.

Documentation Requirements

Documentation must include the specific exercises performed and the patient's response.

Specialty Considerations

Physical therapy documentation should reflect the goals of treatment and progress made.

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, enabling better tracking of disease prevalence and treatment outcomes. This specificity aids in appropriate reimbursement and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding musculoskeletal conditions, enabling better tracking of disease prevalence and treatment outcomes. This specificity aids in appropriate reimbursement and resource allocation.

Reimbursement & Billing Impact

reimbursement and resource allocation.

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 rheumatoid myopathy?

Common symptoms include muscle weakness, pain in the affected areas, fatigue, and difficulty performing daily activities due to joint and muscle involvement.