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v1.0.0
ICD-10 Guide
ICD-10 CodesM05.232

M05.232

Billable

Rheumatoid vasculitis with rheumatoid arthritis of left wrist

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

Code Description

ICD-10 M05.232 is a billable code used to indicate a diagnosis of rheumatoid vasculitis with rheumatoid arthritis of left wrist.

Key Diagnostic Point:

Rheumatoid vasculitis is a serious complication of rheumatoid arthritis (RA), characterized by inflammation of blood vessels that can lead to ischemia and tissue damage. In this case, the left wrist is affected, indicating localized involvement. The wrist joint comprises the distal radius and ulna, carpal bones, and the proximal ends of the metacarpals. RA is an autoimmune disorder that primarily affects synovial joints, leading to synovitis, joint destruction, and systemic manifestations. Patients may present with joint pain, swelling, and stiffness, particularly in the morning. In cases of vasculitis, symptoms may include skin lesions, neuropathy, and systemic symptoms such as fever and malaise. The anatomical complexity of the wrist, combined with the systemic nature of RA and the potential for vascular complications, necessitates careful assessment and documentation.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Involvement of multiple anatomical structures in the wrist.
  • Systemic implications of rheumatoid vasculitis.
  • Need for detailed documentation of joint and systemic symptoms.
  • Potential for overlapping conditions requiring differential diagnosis.

Audit Risk Factors

  • Inadequate documentation of systemic symptoms.
  • Failure to specify laterality of joint involvement.
  • Misclassification of vasculitis severity.
  • Omission of relevant comorbid 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 for joint repair or replacement due to severe damage from RA.

Billing Considerations

Documentation must reflect the severity of joint involvement and any surgical history.

Rheumatology

Documentation Requirements

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

Common Clinical Scenarios

Patients may present with exacerbations of RA requiring adjustments in therapy or monitoring for systemic involvement.

Billing Considerations

Systemic involvement must be documented, including any organ systems affected by vasculitis.

Physical Medicine

Documentation Requirements

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

Common Clinical Scenarios

Rehabilitation scenarios may include physical therapy to improve joint function and mobility.

Billing Considerations

Documentation should address any limitations in daily activities and the impact of RA on quality of life.

Coding Guidelines

Inclusion Criteria

Use M05.232 When
  • Coders must ensure accurate documentation of laterality (left wrist), severity of the condition, and the type of encounter (initial, follow
  • up, etc
  • Specificity in documenting the relationship between rheumatoid arthritis and vasculitis is crucial

Exclusion Criteria

Do NOT use M05.232 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 aspiration in cases of swelling or effusion in the left wrist.

Documentation Requirements

Document the reason for aspiration, findings, and any therapeutic interventions.

Specialty Considerations

Orthopedic and rheumatologic considerations for joint 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, particularly in distinguishing between types of rheumatoid arthritis and associated complications like vasculitis.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding musculoskeletal conditions, particularly in distinguishing between types of rheumatoid arthritis and associated complications like vasculitis.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding musculoskeletal conditions, particularly in distinguishing between types of rheumatoid arthritis and associated complications like vasculitis.

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 vasculitis?

Key symptoms include joint pain and swelling, skin lesions, neuropathy, and systemic symptoms such as fever and malaise. Documentation should reflect both local and systemic manifestations.