M05.311
BillableRheumatoid heart disease with rheumatoid arthritis of right shoulder
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 83 — Rheumatoid Arthritis and Inflammatory Connective Tissue Disease
0.000What This Code Means
Rheumatoid arthritis affecting the right shoulder combined with inflammation of the heart tissue caused by rheumatoid disease.
Coding Tips
- •The '311' designation specifically indicates the right shoulder; do not use this code for left shoulder or bilateral involvement
- •Verify documentation clearly states right shoulder involvement and cardiac manifestations of rheumatoid arthritis
Clinical Significance
This diagnosis indicates severe rheumatoid disease with cardiac complications specifically involving the right shoulder joint. The combination of heart involvement and joint inflammation represents high-risk systemic disease requiring intensive cardiorheumatology management and aggressive immunosuppressive therapy.
Documentation Requirements
- ✓Laboratory-confirmed rheumatoid arthritis diagnosis
- ✓Evidence of rheumatoid heart disease through cardiac assessment
- ✓Right shoulder joint involvement specifically documented
- ✓Active inflammatory process with supporting lab values
- ✓Cardiac function evaluation and monitoring parameters
- ✓Assessment of shoulder joint damage and function
- ✓Documentation of immunosuppressive treatment regimen
- ✓Regular cardiac and rheumatologic monitoring
Commonly Confused Codes
Code Hierarchy
└M05Rheumatoid arthritis with rheumatoid factor└M05.3Rheumatoid heart disease with rheumatoid arthritis└M05.31Rheumatoid heart disease with rheumatoid arthritis of shoulder└M05.311Rheumatoid heart disease with rheumatoid arthritis of right shoulder
└M05.311Rheumatoid heart disease with rheumatoid arthritis of right shoulder