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M05.312

Billable

Rheumatoid heart disease with rheumatoid arthritis of left shoulder

HCC Category Mapping

V28HCC 93Rheumatoid Arthritis and Inflammatory Connective Tissue Disease
0.175
V24HCC 40Rheumatoid Arthritis and Inflammatory Connective Tissue Disease
0.307
ESRDHCC 40Rheumatoid Arthritis and Inflammatory Connective Tissue Disease
0.000
RxHCCHCC 83Rheumatoid Arthritis and Inflammatory Connective Tissue Disease
0.000

What This Code Means

Rheumatoid arthritis affecting the left shoulder combined with inflammation of the heart tissue caused by rheumatoid disease.

Coding Tips

  • The '312' designation specifically indicates the left shoulder; ensure laterality is clearly documented before assigning this code
  • Confirm that both the cardiac involvement and left shoulder arthritis are documented in the medical record

Clinical Significance

Indicates severe systemic rheumatoid disease with cardiac complications involving the left shoulder joint. This represents advanced inflammatory arthropathy with cardiac involvement requiring intensive multidisciplinary care including cardiology and rheumatology management for both joint preservation and cardiac protection.

Documentation Requirements

  • Confirmed rheumatoid arthritis with positive serology
  • Clinical or imaging evidence of rheumatoid heart disease
  • Left shoulder joint involvement clearly specified
  • Evidence of active systemic inflammation
  • Cardiac function assessment and ongoing monitoring
  • Assessment of shoulder joint damage and functional capacity
  • Current immunosuppressive medication regimen
  • Regular cardiorheumatology follow-up documentation

Commonly Confused Codes

Code Hierarchy

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