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M05.171 ICD-10-CM Code: Rheumatoid lung disease with rheumatoid arthritis of right ankle and foot

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

M05.171

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

Rheumatoid lung disease with rheumatoid arthritis of right ankle and foot

A condition where rheumatoid arthritis affects the right ankle and foot and also causes inflammation in the lungs.

Buddy the Bee presenting code insight

Buddy Insight

Indicates severe rheumatoid arthritis with right ankle and foot involvement and concurrent pulmonary manifestations, representing advanced systemic disease with significant mobility impact and respiratory complications.

CMS-HCC V28

HCC 93

RAF 0.175

CMS-HCC V24

HCC 40

RAF 0.307

ACA/HHS

0

0

RAF 0

ESRD/PACE

HCC 40

RAF 0.0

RXHCC

HCC 83

RAF 0.0

Code Trumping

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Code Book Path

Official
M05.1Rheumatoid lung disease with rheumatoid arthritis
M05.17Rheumatoid lung disease with rheumatoid arthritis of ankle and foot
M05.171Rheumatoid lung disease with rheumatoid arthritis of right ankle and foot

Inclusion Terms

Official
  • Rheumatoid lung disease with rheumatoid arthritis, tarsus, metatarsus and phalanges

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for M05.171 in this effective period.

Related Child Codes

Official
M05.172Rheumatoid lung disease with rheumatoid arthritis of left ankle and foot
M05.179Rheumatoid lung disease with rheumatoid arthritis of unspecified ankle and foot

Includes

Official

ICD-10-CM does not list Includes notes for M05.171 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for M05.171 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for M05.171 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for M05.171 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for M05.171 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Confirmed rheumatoid arthritis with positive laboratory findings
Documentation of right ankle and foot joint involvement with inflammatory changes
Evidence of rheumatoid-related lung disease through appropriate studies
Specific notation of right-sided ankle and foot involvement

MEAT Support

HCC Buddy guidance
Confirmed rheumatoid arthritis with positive laboratory findings
Documentation of right ankle and foot joint involvement with inflammatory changes
Evidence of rheumatoid-related lung disease through appropriate studies
Specific notation of right-sided ankle and foot involvement

Audit Caution

HCC Buddy guidance
Confusing right and left ankle/foot documentation
Using when lung disease is not confirmed to be rheumatoid-related
Missing specific documentation of right ankle and foot involvement
Failing to verify both ankle/foot arthritis and lung disease components

Common Mistakes

HCC Buddy guidance
M05.172 — Rheumatoid lung disease with RA of left ankle and foot (different laterality)
M05.179 — Rheumatoid lung disease with RA of unspecified ankle and foot (laterality not documented)
M06.071 — Rheumatoid arthritis of right ankle and foot without lung involvement
M05.161 — Rheumatoid lung disease with RA of right knee (different joint)

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is M05.171 an HCC code?

Yes. M05.171 maps to Rheumatoid Arthritis and Inflammatory Connective Tissue Disease under the CMS-HCC V28 risk adjustment model (and Rheumatoid Arthritis and Inflammatory Connective Tissue Disease under V24).

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

RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. 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.

MEAT Criteria for M05.171

For M05.171to 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 M05.171 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

M05.171 is the ICD-10-CM diagnosis code for rheumatoid lung disease with rheumatoid arthritis of right ankle and foot. A condition where rheumatoid arthritis affects the right ankle and foot and also causes inflammation in the lungs. M05.171 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, M05.171 maps to Rheumatoid Arthritis and Inflammatory Connective Tissue Disease (HCC 93) with a community, non-dual, aged base RAF weight of 0.175. Under the older V24 model, M05.171 mapped to the same category but with a base RAF weight of 0.307, V28 recalibrated weights across the entire model. 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.

This code encompasses both ankle and foot involvement on the right side. Because M05.171 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 M05.171 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • This code encompasses both ankle and foot involvement on the right side
  • Document whether the condition affects one or both structures in the right lower extremity

Clinical Significance

Indicates severe rheumatoid arthritis with right ankle and foot involvement and concurrent pulmonary manifestations, representing advanced systemic disease with significant mobility impact and respiratory complications. This condition affects weight-bearing function and requires comprehensive management.

Documentation Requirements

  • Confirmed rheumatoid arthritis with positive laboratory findings
  • Documentation of right ankle and foot joint involvement with inflammatory changes
  • Evidence of rheumatoid-related lung disease through appropriate studies
  • Specific notation of right-sided ankle and foot involvement
  • Clinical assessment linking lung pathology to rheumatoid etiology
  • Assessment of weight-bearing function and gait abnormalities
  • Treatment plan addressing both foot/ankle preservation and pulmonary management

Commonly Confused Codes

  • M05.172: Rheumatoid lung disease with RA of left ankle and foot (different laterality)
  • M05.179: Rheumatoid lung disease with RA of unspecified ankle and foot (laterality not documented)
  • M06.071: Rheumatoid arthritis of right ankle and foot without lung involvement
  • M05.161: Rheumatoid lung disease with RA of right knee (different joint)
  • M05.151: Rheumatoid lung disease with RA of right hip (different anatomical location)

Child Codes

Code Hierarchy

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