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ICD-10 Guide
ICD-10 CodesM05.271

M05.271

Billable

Rheumatoid vasculitis with rheumatoid arthritis of right ankle and foot

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

Code Description

ICD-10 M05.271 is a billable code used to indicate a diagnosis of rheumatoid vasculitis with rheumatoid arthritis of right ankle and foot.

Key Diagnostic Point:

Rheumatoid vasculitis is a serious complication of rheumatoid arthritis (RA) characterized by inflammation of blood vessels, leading to ischemia and tissue damage. In this case, it specifically affects the right ankle and foot. Anatomically, the ankle joint comprises the tibia, fibula, and talus, while the foot includes multiple bones such as the metatarsals and phalanges. Clinically, patients may present with joint pain, swelling, and systemic symptoms like fatigue and fever. The involvement of vasculitis can lead to skin ulcers, neuropathy, and other systemic manifestations, complicating the management of RA. The pathophysiology involves immune-mediated damage to the vascular endothelium, contributing to joint destruction and functional impairment. Patients may experience significant movement limitations due to pain and swelling, impacting their quality of life and necessitating a multidisciplinary approach to treatment, including pharmacological and rehabilitative strategies.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Involvement of multiple anatomical structures (ankle and foot)
  • Presence of systemic complications (vasculitis)
  • Need for precise documentation of laterality and severity
  • Potential for overlapping diagnoses (rheumatoid arthritis and vasculitis)

Audit Risk Factors

  • Inadequate documentation of systemic involvement
  • Failure to specify laterality (right ankle and foot)
  • Misclassification of rheumatoid arthritis severity
  • Omission of relevant comorbidities or complications

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Orthopedic documentation should include imaging studies (X-rays, MRIs) to assess joint integrity, functional assessments to evaluate mobility, and detailed notes on joint swelling and tenderness.

Common Clinical Scenarios

Common scenarios include surgical interventions for joint repair or replacement, and management of acute exacerbations of arthritis.

Billing Considerations

Joint-specific considerations include the assessment of joint stability, range of motion, and the impact of vasculitis on surgical outcomes.

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 flares of rheumatoid arthritis and monitoring for complications of vasculitis.

Billing Considerations

Systemic involvement may necessitate coordination with other specialties, and documentation should reflect the complexity of managing both RA and vasculitis.

Physical Medicine

Documentation Requirements

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

Common Clinical Scenarios

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

Billing Considerations

Considerations include the impact of pain on daily activities and the need for adaptive strategies to enhance mobility.

Coding Guidelines

Inclusion Criteria

Use M05.271 When
  • Official coding guidelines require coders to specify laterality (right ankle and foot), document the severity of rheumatoid arthritis, and indicate the encounter type (initial, follow
  • up, etc
  • Accurate coding also necessitates capturing any related complications or comorbidities

Exclusion Criteria

Do NOT use M05.271 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 swelling management in rheumatoid arthritis patients.

Documentation Requirements

Document the joint involved, the procedure performed, and the patient's response.

Specialty Considerations

Orthopedic and rheumatologic considerations include assessing joint fluid for inflammatory markers.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has increased specificity in coding musculoskeletal conditions, allowing for better tracking of complications like vasculitis in rheumatoid arthritis. This specificity aids in treatment planning and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has increased specificity in coding musculoskeletal conditions, allowing for better tracking of complications like vasculitis in rheumatoid arthritis. This specificity aids in treatment planning and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has increased specificity in coding musculoskeletal conditions, allowing for better tracking of complications like vasculitis in rheumatoid arthritis. This specificity aids in treatment planning 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 key documentation requirements for coding M05.271?

Key documentation requirements include detailed clinical notes on joint involvement, systemic symptoms, laboratory results indicating inflammation, and any imaging studies that support the diagnosis of rheumatoid vasculitis.