M02.30 ICD-10-CM Code: Reiter's disease, unspecified site
HCC Buddy Code Card
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FY 2026 Apr update / Diseases of the musculoskeletal system and connective tissue (M00-M99) / Infectious arthropathies (M00-M02)
M02.30
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceReiter's disease, unspecified site
Reiter's disease, a type of reactive arthritis that causes joint inflammation, typically following an infection, affecting an unspecified body site.
Buddy Insight
Reiter's disease represents a classic triad of reactive arthritis typically involving joints, urethritis, and conjunctivitis, though this unspecified site code captures cases where the specific anatomical location is not documented.
CMS-HCC V28
MappedHCC 94
RAF 0.268
CMS-HCC V24
MappedHCC 40
RAF 0.421
ACA/HHS
MappedHCC 57
Varies by metal level
ESRD/PACE
MappedHCC 40
RAF 0.058
RXHCC
MappedHCC 83
RAF 0.222
Code Book Path
Inclusion Terms
Official- Reactive arthritis
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for M02.30 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for M02.30 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for M02.30 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for M02.30 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for M02.30 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for M02.30 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is M02.30 an HCC code?
Yes. M02.30 (Reiter's disease, unspecified site) maps to Systemic Lupus Erythematosus and Other Specified Systemic Connective Tissue Disorders under the CMS-HCC V28 risk adjustment model (and Rheumatoid Arthritis and Inflammatory Connective Tissue Disease under V24), with a community non-dual aged RAF of 0.268. It is billable for payment year 2026.
Coder answer: M02.30 is billable and maps to V28 HCC 94, Systemic Lupus Erythematosus and Other Specified Systemic Connective Tissue Disorders. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.
- Code
- M02.30
- Description
- Reiter's disease, unspecified site
- HCC (V28)
- HCC 94 — Systemic Lupus Erythematosus and Other Specified Systemic Connective Tissue Disorders
- RAF
- 0.268
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
Work M02.30 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for M02.30
For M02.30 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed M02.30 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
M02.30 is the ICD-10-CM diagnosis code for reiter's disease, unspecified site. Reiter's disease, a type of reactive arthritis that causes joint inflammation, typically following an infection, affecting an unspecified body site. M02.30 sits in the ICD-10-CM chapter for diseases of the musculoskeletal system and connective tissue (m00-m99), within the section covering infectious arthropathies (m00-m02).
Under the CMS-HCC V28 risk adjustment model, M02.30 maps to Systemic Lupus Erythematosus and Other Specified Systemic Connective Tissue Disorders (HCC 94) with a community, non-dual, aged base RAF weight of 0.268. Under the older CMS-HCC V24 model, M02.30 maps to Rheumatoid Arthritis and Inflammatory Connective Tissue Disease (HCC 40) with a community, non-dual, aged base RAF weight of 0.421. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
Reiter's disease is a triad of arthritis, urethritis, and conjunctivitis; document all components if present. Because M02.30 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M02.30 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Reiter's disease is a triad of arthritis, urethritis, and conjunctivitis; document all components if present
- •Query provider for specific site involvement to assign more specific code if possible
Clinical Significance
Reiter's disease represents a classic triad of reactive arthritis typically involving joints, urethritis, and conjunctivitis, though this unspecified site code captures cases where the specific anatomical location is not documented. This condition requires ongoing management due to its chronic inflammatory nature and potential for recurrence and complications.
Documentation Requirements
- ✓Clinical diagnosis of Reiter's disease or reactive arthritis
- ✓History of preceding infection (often genitourinary or gastrointestinal)
- ✓Evidence of arthritis symptoms without specified anatomical site
- ✓Documentation of classic triad components when present
- ✓Chronic or recurrent nature of symptoms
- ✓Exclusion of other arthritis types
- ✓Laboratory or clinical findings supporting reactive arthritis diagnosis
Commonly Confused Codes
- •M02.311: Reiter's disease, right shoulder (use when specific site documented)
- •M02.30: Postdysenteric arthropathy, unspecified site (different trigger infection)
- •M06.9: Rheumatoid arthritis, unspecified (autoimmune, not reactive)
- •M35.2: Behçet's disease (different systemic inflammatory condition)
- •N34.1: Nonspecific urethritis (urethritis component alone, not full syndrome)