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ICD-10 Guide
ICD-10 CodesM05.52

M05.52

Billable

Rheumatoid polyneuropathy with rheumatoid arthritis of elbow

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

Code Description

ICD-10 M05.52 is a billable code used to indicate a diagnosis of rheumatoid polyneuropathy with rheumatoid arthritis of elbow.

Key Diagnostic Point:

Rheumatoid polyneuropathy is a complication of rheumatoid arthritis (RA) characterized by peripheral nerve damage due to systemic inflammation. The elbow joint, commonly affected in RA, can exhibit synovitis, joint erosion, and deformities. Anatomically, the elbow consists of the humerus, radius, and ulna, with surrounding ligaments and tendons that facilitate movement. Clinically, patients may present with pain, swelling, and reduced range of motion in the elbow, alongside symptoms of neuropathy such as numbness or tingling in the hands. The pathophysiology involves immune-mediated inflammation leading to joint destruction and potential nerve compression due to swelling or structural changes. Early diagnosis and management are crucial to prevent irreversible damage and maintain function.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Involvement of multiple body systems (musculoskeletal and neurological)
  • Need for precise documentation of joint involvement and severity
  • Differentiation from other types of neuropathy
  • Potential for co-existing conditions affecting coding

Audit Risk Factors

  • Inadequate documentation of joint involvement and severity
  • Failure to document neurological symptoms related to polyneuropathy
  • Misclassification of the type of arthritis or neuropathy
  • Lack of evidence for treatment efficacy or response

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed imaging reports (X-rays, MRIs) showing joint damage, functional assessments of elbow range of motion, and any surgical interventions.

Common Clinical Scenarios

Patients requiring joint injections, arthroscopy, or joint replacement due to severe RA.

Billing Considerations

Documenting the degree of joint deformity and functional limitations is critical for treatment planning.

Rheumatology

Documentation Requirements

Lab results indicating inflammatory markers (e.g., ESR, CRP), disease activity scores, and patient-reported outcomes.

Common Clinical Scenarios

Management of systemic symptoms and medication adjustments based on disease progression.

Billing Considerations

Monitoring for systemic involvement and comorbidities is essential for comprehensive care.

Physical Medicine

Documentation Requirements

Functional assessments, rehabilitation goals, and progress notes detailing mobility and strength.

Common Clinical Scenarios

Rehabilitation post-surgery or during flare-ups to improve joint function and reduce pain.

Billing Considerations

Assessing the need for assistive devices and home modifications to enhance patient mobility.

Coding Guidelines

Inclusion Criteria

Use M05.52 When
  • Follow official coding guidelines for laterality (e
  • , right or left elbow), severity of the rheumatoid arthritis, and the type of encounter (initial, follow
  • up, etc
  • Ensure accurate documentation of both the polyneuropathy and the rheumatoid arthritis

Exclusion Criteria

Do NOT use M05.52 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

20610CPT Code

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

Clinical Scenario

Used for joint injections to manage inflammation in the elbow.

Documentation Requirements

Document the joint injected, the amount of medication used, and the patient's response.

Specialty Considerations

Orthopedic considerations for joint stability and rheumatologic considerations for disease management.

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 progression and treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding musculoskeletal conditions, enabling better tracking of disease progression and treatment outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding musculoskeletal conditions, enabling better tracking of disease progression and treatment outcomes.

Resources

Clinical References

  • •
    American College of Rheumatology Guidelines

Coding & Billing References

  • •
    American College of Rheumatology Guidelines

Frequently Asked Questions

What are the key symptoms of rheumatoid polyneuropathy?

Key symptoms include numbness, tingling, and weakness in the extremities, often accompanied by joint pain and swelling due to rheumatoid arthritis.