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v1.0.0
ICD-10 Guide
ICD-10 CodesM05.332

M05.332

Billable

Rheumatoid heart disease with rheumatoid arthritis of left wrist

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

Code Description

ICD-10 M05.332 is a billable code used to indicate a diagnosis of rheumatoid heart disease with rheumatoid arthritis of left wrist.

Key Diagnostic Point:

Rheumatoid heart disease is a complication of rheumatoid arthritis (RA), characterized by inflammation of the heart tissues, which can lead to pericarditis, myocarditis, and valvular heart disease. The left wrist involvement indicates that the patient has active rheumatoid arthritis affecting the wrist joint, which is commonly affected in RA due to its synovial nature. Clinically, patients may present with joint pain, swelling, and stiffness, particularly in the morning or after periods of inactivity. Anatomically, the wrist consists of eight carpal bones, and the inflammation can lead to joint deformities and functional limitations. The pathophysiology involves an autoimmune response where the immune system mistakenly attacks the synovial membrane, leading to chronic inflammation and joint damage. Patients may experience decreased range of motion and functional impairment in daily activities, necessitating a multidisciplinary approach for management.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Involvement of multiple body systems (musculoskeletal and cardiovascular)
  • Need for precise documentation of joint involvement and severity
  • Potential for systemic complications affecting coding
  • Variability in clinical presentation and treatment approaches

Audit Risk Factors

  • Inadequate documentation of joint involvement and severity
  • Failure to capture systemic manifestations of rheumatoid arthritis
  • Misclassification of the primary diagnosis versus secondary conditions
  • Lack of supporting evidence for treatment modalities used

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed imaging reports (X-rays, MRIs) showing joint damage, functional assessments documenting range of motion and strength.

Common Clinical Scenarios

Patients presenting with wrist pain and swelling, requiring surgical intervention for joint repair or replacement.

Billing Considerations

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

Rheumatology

Documentation Requirements

Lab results showing inflammatory markers (e.g., ESR, CRP), disease activity scores, and treatment response assessments.

Common Clinical Scenarios

Patients with exacerbations of RA requiring adjustments in immunosuppressive therapy or biologics.

Billing Considerations

Monitoring for systemic involvement and documenting any cardiovascular symptoms related to rheumatoid heart disease.

Physical Medicine

Documentation Requirements

Functional assessments including mobility evaluations, assistive device needs, and rehabilitation progress notes.

Common Clinical Scenarios

Patients undergoing physical therapy for wrist rehabilitation post-surgery or during flare-ups.

Billing Considerations

Assessing and documenting mobility limitations and the impact on daily living activities.

Coding Guidelines

Inclusion Criteria

Use M05.332 When
  • Coders must ensure accurate documentation of laterality (left wrist), severity of rheumatoid arthritis, and any associated systemic conditions
  • Encounter type (initial, follow
  • up, or exacerbation) must also be documented appropriately

Exclusion Criteria

Do NOT use M05.332 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 the left wrist.

Documentation Requirements

Document the indication for the procedure, joint involved, and any complications.

Specialty Considerations

Orthopedic and rheumatologic documentation should include joint assessment and treatment response.

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 those with systemic involvement, improving the accuracy of patient records and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding musculoskeletal conditions, particularly those with systemic involvement, improving the accuracy of patient records and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 M05.332?

Key documentation includes detailed descriptions of joint involvement, systemic symptoms, treatment plans, and response to therapy. Ensure that laterality is clearly indicated and that any imaging or lab results supporting the diagnosis are included.