Skip to content
HCC Buddy home

M05.031 ICD-10-CM Code: Felty's syndrome, right wrist

M05.031 maps to CMS-HCC V28 93. A source-labeled RAF reference is available. Documentation must support MEAT. MEAT criteria · RAF Calculator · HCC Buddy coding tools

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

FY 2026 Apr update / Diseases of the musculoskeletal system and connective tissue (M00-M99) / Inflammatory polyarthropathies (M05-M14)

M05.031

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Felty's syndrome, right wrist

Felty's syndrome affecting the right wrist, characterized by rheumatoid arthritis, enlarged spleen, and low white blood cell count.

Buddy the Bee presenting code insight

Buddy Insight

Felty's syndrome affecting the right wrist combines the debilitating effects of rheumatoid joint destruction with life-threatening hematologic abnormalities including neutropenia and splenomegaly.

CMS-HCC V28

HCC 93

Code-level coefficient reference

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

HCC 056

Code-level coefficient reference

ESRD/PACE

HCC 40

Code-level coefficient reference

RXHCC

HCC 83

Code-level coefficient reference

Code Book Path

Official
M05.0Felty's syndrome
M05.03Felty's syndrome, wrist
M05.031Felty's syndrome, right wrist

Inclusion Terms

Official
  • Felty's syndrome, carpal bones

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for M05.031 in this effective period.

Related Child Codes

Official
M05.032Felty's syndrome, left wrist
M05.039Felty's syndrome, unspecified wrist

Includes

Official

ICD-10-CM does not list Includes notes for M05.031 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for M05.031 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for M05.031 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for M05.031 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for M05.031 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Specific documentation of rheumatoid arthritis affecting the right wrist
Clinical or imaging evidence of splenomegaly
Laboratory confirmation of neutropenia with quantitative counts
Right wrist involvement explicitly documented with laterality

MEAT Support

HCC Buddy guidance
Specific documentation of rheumatoid arthritis affecting the right wrist
Clinical or imaging evidence of splenomegaly
Laboratory confirmation of neutropenia with quantitative counts
Right wrist involvement explicitly documented with laterality

Audit Caution

HCC Buddy guidance
Using left wrist code when right wrist is specifically documented
Failing to recognize the complete Felty's syndrome when all components are present
Missing the hematologic elements that distinguish this from standard RA
Not ensuring laboratory confirmation of neutropenia

Common Mistakes

HCC Buddy guidance
M05.9 — Seropositive rheumatoid arthritis without Felty's syndrome components
M05.032 — Same condition but affecting left wrist instead of right
M06.9 — Rheumatoid arthritis unspecified without hematologic involvement
D70.9 — Neutropenia without the rheumatoid arthritis context

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 M05.031 an HCC code?

Yes. M05.031 (Felty's syndrome, right wrist) maps to HCC 93, Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.617. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: M05.031 is billable and maps to V28 HCC 93, Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code
M05.031
Description
Felty's syndrome, right wrist
HCC (V28)
HCC 93 — Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders
RAF reference coefficient
0.617
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 93, Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders
0.617
ESRDHCC 40, Rheumatoid Arthritis and Inflammatory Connective Tissue Disease
Not separately weighted
RxHCCHCC 83, Rheumatoid Arthritis and Other Inflammatory Polyarthropathy
Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. 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 context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work M05.031 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT Criteria for M05.031

For M05.031 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 M05.031 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

Get the V28 mapping + MEAT cheat sheet

One printable reference: check representative V28 mappings and the documentation reminders your note needs. Free, no card.

Free PDF. No card. Unsubscribe anytime.

What This Code Means

M05.031 is the ICD-10-CM diagnosis code for felty's syndrome, right wrist. Felty's syndrome affecting the right wrist, characterized by rheumatoid arthritis, enlarged spleen, and low white blood cell count. M05.031 sits in the ICD-10-CM chapter for diseases of the musculoskeletal system and connective tissue (m00-m99), within the section covering inflammatory polyarthropathies (m05-m14).

Under the CMS-HCC V28 risk adjustment model, M05.031 maps to Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders (HCC 93) with a source-labeled community, non-dual, aged reference coefficient of 0.617. No V24 mapping is shown for M05.031; use the applicable model and payment year when reviewing the V28 mapping. 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. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

Confirm right wrist is the documented site of Felty's syndrome involvement. Because M05.031 maps to an HCC category, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) before the diagnosis is used for risk adjustment. 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, source-labeled coefficient references, and MEAT documentation criteria for M05.031 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Confirm right wrist is the documented site of Felty's syndrome involvement
  • •Do not use this code for left wrist or unspecified wrist involvement

Clinical Significance

Felty's syndrome affecting the right wrist combines the debilitating effects of rheumatoid joint destruction with life-threatening hematologic abnormalities including neutropenia and splenomegaly. This condition requires immediate recognition and aggressive management due to the high risk of serious infections and multi-system complications.

Documentation Requirements

  • ✓Specific documentation of rheumatoid arthritis affecting the right wrist
  • ✓Clinical or imaging evidence of splenomegaly
  • ✓Laboratory confirmation of neutropenia with quantitative counts
  • ✓Right wrist involvement explicitly documented with laterality
  • ✓Assessment of wrist function and inflammatory activity
  • ✓Infection screening and immune status evaluation
  • ✓Treatment regimen including immunomodulatory therapy
  • ✓Monitoring protocols for hematologic and rheumatologic parameters

Commonly Confused Codes

  • •M05.9: Seropositive rheumatoid arthritis without Felty's syndrome components
  • •M05.032: Same condition but affecting left wrist instead of right
  • •M06.9: Rheumatoid arthritis unspecified without hematologic involvement
  • •D70.9: Neutropenia without the rheumatoid arthritis context
  • •M25.531: Pain in right wrist without inflammatory or hematologic components

Child Codes

M05.031Felty's syndrome, right wrist
HCC 93
M05.032Felty's syndrome, left wrist
HCC 93
M05.039Felty's syndrome, unspecified wrist
HCC 93

Code Hierarchy

└M05Rheumatoid arthritis with rheumatoid factor└M05.0Felty's syndrome└M05.03Felty's syndrome, wrist└M05.031Felty's syndrome, right wrist
└M05.031Felty's syndrome, right wrist

Because M05.031 maps to an HCC category, the documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) before the diagnosis is used for risk adjustment.

M05.031 maps to CMS-HCC V28 category 93, Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. The mapping identifies a payment HCC category for M05.031. Review its source-labeled HCC coefficient above, check the RAF Calculator with complete member context for CMS-HCC V28 PY2026, and confirm the documentation the chart needs before the code is submitted. HCC Buddy shows no RAF score unless every required source and calculation check passes.

More on M05.031

Related condition guides

Work M05.031 in HCC Buddy

Open M05.031 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.

Open in Code BookOpen in EncoderStart Pro