L40.51
BillableDistal interphalangeal psoriatic arthropathy
HCC Category Mapping
V28HCC 93 — Rheumatoid Arthritis and Inflammatory Connective Tissue Disease
0.175V24HCC 40 — Rheumatoid Arthritis and Inflammatory Connective Tissue Disease
0.307ESRDHCC 40 — Rheumatoid Arthritis and Inflammatory Connective Tissue Disease
0.000RxHCCHCC 81 — Psoriatic and Enteropathic Arthropathies
0.000What This Code Means
A type of psoriatic arthritis that specifically affects the small joints at the tips of the fingers and toes, causing pain, swelling, and potential nail changes.
Coding Tips
- •Document which digits are affected and the severity of joint involvement
- •Note any associated nail dystrophy or functional impairment in fine motor activities
Clinical Significance
Distal interphalangeal psoriatic arthropathy is a specific pattern of psoriatic arthritis targeting the DIP joints of the fingers and toes, often accompanied by nail changes. It is the most classically associated pattern with psoriasis and helps distinguish psoriatic arthritis from rheumatoid arthritis which typically spares the DIP joints. Accurate capture allows for appropriate risk adjustment and treatment planning.
Documentation Requirements
- ✓Provider documentation of distal interphalangeal psoriatic arthropathy
- ✓Documentation of DIP joint involvement (which fingers/toes affected)
- ✓Associated nail changes (pitting, onycholysis, dystrophy) if present
- ✓Radiographic findings of DIP joint erosion or new bone formation if available
- ✓Current treatment plan and disease activity assessment
- ✓Associated psoriasis documentation
Commonly Confused Codes
L40.50 (Arthropathic psoriasis, unspecified) — use L40.51 when DIP involvement is specifically documentedM15.1 (Heberden's nodes) — osteoarthritis of DIP joints, not inflammatory; different pathologyL40.52 (Psoriatic arthritis mutilans) — severe destructive variant, more than just DIP involvementM06.9 (Rheumatoid arthritis, unspecified) — rheumatoid arthritis typically spares DIP joints
Code Hierarchy
└L40Psoriasis└L40.5Arthropathic psoriasis└L40.51Distal interphalangeal psoriatic arthropathy
└L40.51Distal interphalangeal psoriatic arthropathy