M05.119

Billable

Rheumatoid lung disease with rheumatoid arthritis of unspecified shoulder

HCC Category Mapping

V28HCC 93 — Rheumatoid Arthritis and Inflammatory Connective Tissue Disease

0.175

V24HCC 40 — Rheumatoid Arthritis and Inflammatory Connective Tissue Disease

0.307

ESRDHCC 40 — Rheumatoid Arthritis and Inflammatory Connective Tissue Disease

0.000

RxHCCHCC 83 — Rheumatoid Arthritis and Inflammatory Connective Tissue Disease

0.000

What This Code Means

Rheumatoid arthritis of the shoulder combined with lung disease when the specific shoulder (left or right) is not documented.

Coding Tips

•Use only when laterality cannot be determined from documentation
•Query the provider to determine right versus left shoulder involvement for more specific coding when possible

Clinical Significance

This code represents a severe systemic manifestation of rheumatoid arthritis involving both joint inflammation and pulmonary complications. The combination significantly increases morbidity risk and requires intensive monitoring for respiratory function deterioration and disease progression.

Documentation Requirements

✓Confirmed diagnosis of rheumatoid arthritis with positive serological markers
✓Evidence of lung disease related to rheumatoid arthritis (imaging, pulmonary function tests)
✓Documentation of shoulder joint involvement with inflammatory changes
✓Specific notation that shoulder laterality is unspecified or unknown
✓Clinical assessment linking lung disease to rheumatoid arthritis etiology
✓Exclusion of other causes of lung disease
✓Current treatment plan for both joint and pulmonary manifestations

Commonly Confused Codes

M05.111 — Rheumatoid lung disease with RA of right shoulder (requires specific laterality)M05.112 — Rheumatoid lung disease with RA of left shoulder (requires specific laterality)M06.9 — Rheumatoid arthritis, unspecified (lacks lung disease component)J84.10 — Pulmonary fibrosis, unspecified (not linked to rheumatoid arthritis)M05.10 — Rheumatoid lung disease with RA of unspecified site (shoulder not specified)

Code Hierarchy

└M05Rheumatoid arthritis with rheumatoid factor └M05.1Rheumatoid lung disease with rheumatoid arthritis └M05.11Rheumatoid lung disease with rheumatoid arthritis of shoulder └M05.119Rheumatoid lung disease with rheumatoid arthritis of unspecified shoulder

└M05.119Rheumatoid lung disease with rheumatoid arthritis of unspecified shoulder