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ICD-10 Guide
ICD-10 CodesM05.551

M05.551

Billable

Rheumatoid polyneuropathy with rheumatoid arthritis of right hip

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

Code Description

ICD-10 M05.551 is a billable code used to indicate a diagnosis of rheumatoid polyneuropathy with rheumatoid arthritis of right hip.

Key Diagnostic Point:

Rheumatoid polyneuropathy is a complication of rheumatoid arthritis (RA), characterized by peripheral nerve damage due to systemic inflammation. The right hip joint is commonly affected in RA, leading to synovitis, joint erosion, and functional impairment. Anatomically, the hip joint comprises the femoral head and the acetabulum, surrounded by ligaments and muscles that facilitate movement. In RA, inflammatory mediators can lead to neuropathic pain and sensory deficits, complicating the clinical picture. Patients may present with joint pain, stiffness, and reduced range of motion in the right hip, alongside symptoms of neuropathy such as tingling, numbness, or weakness in the lower extremities. The interplay between joint inflammation and nerve involvement necessitates a comprehensive approach to diagnosis and management.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Involvement of multiple body systems (musculoskeletal and nervous)
  • Need for precise documentation of joint involvement and laterality
  • Variability in clinical presentation and severity
  • Potential for overlapping symptoms with other conditions

Audit Risk Factors

  • Inadequate documentation of joint involvement and severity
  • Failure to specify laterality (right hip)
  • Insufficient evidence of polyneuropathy diagnosis
  • Misclassification of rheumatoid arthritis severity

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed imaging reports (X-rays, MRIs) showing joint erosion and inflammation, functional assessments documenting range of motion and pain levels.

Common Clinical Scenarios

Surgical interventions such as hip arthroplasty or joint injections for pain management.

Billing Considerations

Documenting the extent of joint damage and functional limitations is crucial for treatment planning.

Rheumatology

Documentation Requirements

Laboratory tests for inflammatory markers (e.g., ESR, CRP), disease activity scores, and patient-reported outcomes.

Common Clinical Scenarios

Management of systemic symptoms and medication adjustments based on disease progression.

Billing Considerations

Monitoring for systemic involvement and potential complications of RA is essential.

Physical Medicine

Documentation Requirements

Functional assessments including mobility evaluations and rehabilitation goals.

Common Clinical Scenarios

Rehabilitation programs focusing on improving joint function and reducing neuropathic symptoms.

Billing Considerations

Addressing mobility limitations and the need for assistive devices is critical for patient care.

Coding Guidelines

Inclusion Criteria

Use M05.551 When
  • Coders must ensure accurate documentation of laterality (right hip), specify the severity of rheumatoid arthritis, and include details of polyneuropathy
  • Encounter type (initial, follow
  • up) must also be documented appropriately

Exclusion Criteria

Do NOT use M05.551 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 injections to manage inflammation in the right hip.

Documentation Requirements

Document the joint involved, indication for injection, and any imaging guidance used.

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, 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 M05.551?

Key documentation includes clear identification of the right hip involvement, evidence of rheumatoid arthritis diagnosis, details of polyneuropathy symptoms, and functional assessments to support treatment decisions.