M05.459
BillableRheumatoid myopathy with rheumatoid arthritis of unspecified hip
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 with muscle weakness affecting the hip when the specific side (left or right) is not documented.
Coding Tips
- •Use only when hip involvement is confirmed but laterality is not specified
- •Query provider for clarification on which hip is affected to allow for more specific coding
Clinical Significance
This diagnosis captures rheumatoid arthritis with myopathy affecting the hip when specific laterality cannot be determined from available documentation. The combination indicates severe systemic disease requiring comprehensive management of both inflammatory joint disease and muscle pathology.
Documentation Requirements
- ✓Confirmed rheumatoid arthritis diagnosis with supporting clinical evidence
- ✓Documentation of hip involvement without laterality specification
- ✓Evidence of myopathy with muscle weakness or atrophy
- ✓Clinical rationale for why hip laterality cannot be determined
- ✓Assessment of functional impact on mobility and ambulation
- ✓Exclusion of other causes of hip pain and muscle weakness
- ✓Treatment plan addressing both hip arthritis and systemic myopathy
Commonly Confused Codes
M05.451 — Rheumatoid myopathy with RA of right hip (when laterality known)M05.452 — Rheumatoid myopathy with RA of left hip (when laterality known)M06.859 — Other specified rheumatoid arthritis of unspecified hip (without myopathy)M25.559 — Pain in unspecified hip (symptom only)M16.9 — Osteoarthritis of hip, unspecified (different arthritis type)
Code Hierarchy
└M05Rheumatoid arthritis with rheumatoid factor└M05.4Rheumatoid myopathy with rheumatoid arthritis└M05.45Rheumatoid myopathy with rheumatoid arthritis of hip└M05.459Rheumatoid myopathy with rheumatoid arthritis of unspecified hip
└M05.459Rheumatoid myopathy with rheumatoid arthritis of unspecified hip