M05.451

Billable

Rheumatoid myopathy with rheumatoid arthritis of right hip

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

A condition where rheumatoid arthritis causes inflammation and muscle weakness in the right hip.

Coding Tips

•Hip involvement represents lower extremity manifestation; ensure documentation confirms hip location
•Verify both myopathy and rheumatoid arthritis are documented for this combination code

Clinical Significance

This diagnosis indicates rheumatoid arthritis affecting the right hip with associated myopathy, representing severe systemic disease with potential for significant mobility impairment. Hip involvement in RA often leads to functional limitations and may require joint replacement, while myopathy adds complexity to treatment planning.

Documentation Requirements

✓Confirmed rheumatoid arthritis diagnosis with clinical or laboratory evidence
✓Specific documentation of right hip joint involvement
✓Clinical evidence of myopathy with muscle weakness or atrophy
✓Imaging studies demonstrating inflammatory changes in right hip
✓Assessment of mobility and functional limitations
✓Documentation of muscle weakness distinct from joint limitation
✓Treatment plan addressing both hip arthritis and systemic myopathy

Commonly Confused Codes

M05.452 — Rheumatoid myopathy with RA of left hip (different laterality)M05.459 — Rheumatoid myopathy with RA of unspecified hip (when laterality unknown)M06.851 — Other specified rheumatoid arthritis, right hip (without myopathy)M16.11 — Unilateral primary osteoarthritis, right hip (different arthritis type)G72.9 — Myopathy, unspecified (lacks RA component)

Code Hierarchy

└M05Rheumatoid arthritis with rheumatoid factor └M05.4Rheumatoid myopathy with rheumatoid arthritis └M05.45Rheumatoid myopathy with rheumatoid arthritis of hip └M05.451Rheumatoid myopathy with rheumatoid arthritis of right hip

└M05.451Rheumatoid myopathy with rheumatoid arthritis of right hip