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ICD-10 Guide
ICD-10 CodesM05.632

M05.632

Billable

Rheumatoid arthritis of left wrist with involvement of other organs and systems

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

Code Description

ICD-10 M05.632 is a billable code used to indicate a diagnosis of rheumatoid arthritis of left wrist with involvement of other organs and systems.

Key Diagnostic Point:

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disorder characterized by synovial inflammation and joint destruction. The left wrist, comprising the distal radius, ulna, and carpal bones, is commonly affected in RA, leading to pain, swelling, and reduced range of motion. The disease can also involve systemic manifestations, affecting organs such as the lungs, heart, and eyes. Clinically, patients may present with morning stiffness, joint deformities, and systemic symptoms like fatigue and malaise. The pathophysiology involves immune-mediated synovitis, leading to the production of inflammatory cytokines and autoantibodies, which contribute to joint damage and systemic involvement. Early diagnosis and management are crucial to prevent irreversible joint damage and improve quality of life.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Involvement of multiple organ systems complicates documentation.
  • Need for precise laterality and joint specificity.
  • Variability in clinical presentation and severity.
  • Potential for overlapping diagnoses with other autoimmune conditions.

Audit Risk Factors

  • Inadequate documentation of systemic involvement.
  • Failure to specify laterality or joint involvement.
  • Misclassification of RA severity.
  • Lack of supporting evidence for co-morbid conditions.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Orthopedic documentation should include imaging studies (X-rays, MRIs) to assess joint damage and functional assessments to evaluate range of motion and strength.

Common Clinical Scenarios

Common scenarios include surgical interventions such as synovectomy or joint replacement due to severe joint destruction.

Billing Considerations

Joint-specific considerations include documenting the extent of deformity and functional limitations.

Rheumatology

Documentation Requirements

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

Common Clinical Scenarios

Scenarios often involve managing flares of RA and adjusting DMARD therapy based on disease activity.

Billing Considerations

Systemic involvement should be documented, including any extra-articular manifestations.

Physical Medicine

Documentation Requirements

Functional assessments should evaluate mobility, strength, and the need for assistive devices.

Common Clinical Scenarios

Rehabilitation scenarios may include physical therapy for joint mobility and strength training.

Billing Considerations

Documentation should address mobility limitations and the impact on daily activities.

Coding Guidelines

Inclusion Criteria

Use M05.632 When
  • 10 coding guidelines require specificity in laterality (left wrist), severity of the condition, and documentation of any systemic involvement
  • Each encounter should reflect the current status of the disease

Exclusion Criteria

Do NOT use M05.632 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 effusion management in RA patients.

Documentation Requirements

Document the joint involved, the procedure performed, and the indication for the procedure.

Specialty Considerations

Orthopedic and rheumatologic considerations include the need for imaging guidance.

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.

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.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding musculoskeletal conditions, enabling better tracking of disease prevalence 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 documentation requirements for coding rheumatoid arthritis?

Key documentation includes specifying the affected joints, laterality, any systemic involvement, and the severity of the disease. Laboratory results and imaging studies should also be included to support the diagnosis.