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ICD-10 Guide
ICD-10 CodesM05.031

M05.031

Billable

Felty's syndrome, right wrist

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

Code Description

ICD-10 M05.031 is a billable code used to indicate a diagnosis of felty's syndrome, right wrist.

Key Diagnostic Point:

Felty's syndrome is a rare complication of rheumatoid arthritis characterized by the triad of rheumatoid arthritis, splenomegaly, and neutropenia. The right wrist may be affected due to the systemic inflammatory process that leads to synovitis, joint erosion, and deformity. Anatomically, the wrist consists of the distal radius and ulna, along with the carpal bones, which articulate with the metacarpals. In Felty's syndrome, the inflammatory response can lead to joint swelling, pain, and reduced range of motion. Clinically, patients may present with symptoms such as joint pain, stiffness, and systemic manifestations like fatigue and recurrent infections due to neutropenia. The pathophysiology involves immune dysregulation, leading to increased autoantibody production and systemic inflammation, which can exacerbate joint damage and functional impairment.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires understanding of autoimmune pathology and its musculoskeletal manifestations.
  • Involves specific anatomical knowledge of the wrist joint and surrounding structures.
  • Documentation must reflect both systemic and localized symptoms.
  • Differentiation from other forms of arthritis and related conditions is necessary.

Audit Risk Factors

  • Inadequate documentation of systemic symptoms related to Felty's syndrome.
  • Failure to document laterality accurately, especially in cases with bilateral involvement.
  • Misclassification of the condition due to lack of specificity in clinical notes.
  • Omission of relevant laboratory findings such as neutrophil counts.

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 for joint repair or replacement due to severe erosion.

Billing Considerations

Joint-specific considerations include documenting the severity of joint involvement and any deformities present.

Rheumatology

Documentation Requirements

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

Common Clinical Scenarios

Autoimmune scenarios may involve managing flare-ups and adjusting DMARD therapy.

Billing Considerations

Systemic involvement must be documented, including any complications arising from neutropenia.

Physical Medicine

Documentation Requirements

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

Common Clinical Scenarios

Rehabilitation scenarios may focus on restoring function post-surgery or managing chronic pain.

Billing Considerations

Mobility limitations should be documented, including the impact on daily activities.

Coding Guidelines

Inclusion Criteria

Use M05.031 When
  • 10 coding guidelines require accurate documentation of laterality (right wrist), severity of symptoms, and the type of encounter (initial, follow
  • up, etc
  • Specificity in documenting the relationship between rheumatoid arthritis and Felty's syndrome is crucial

Exclusion Criteria

Do NOT use M05.031 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 managing joint effusion in the right wrist.

Documentation Requirements

Document the indication for the procedure, including joint swelling and pain.

Specialty Considerations

Orthopedic considerations include assessing joint stability and function post-procedure.

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 complications like Felty's syndrome and its systemic effects.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding musculoskeletal conditions, enabling better tracking of complications like Felty's syndrome and its systemic effects.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding musculoskeletal conditions, enabling better tracking of complications like Felty's syndrome and its systemic effects.

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 Felty's syndrome?

Key symptoms include joint pain and swelling, particularly in the wrists, fatigue, splenomegaly, and recurrent infections due to neutropenia.