M05.461
BillableRheumatoid myopathy with rheumatoid arthritis of right knee
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
A condition where rheumatoid arthritis causes inflammation and muscle weakness in the right knee.
Coding Tips
- •Distinguish knee involvement from hip or ankle; ensure documentation specifies knee location
- •Confirm myopathy component is documented alongside the rheumatoid arthritis diagnosis
Clinical Significance
This diagnosis represents rheumatoid arthritis affecting the right knee with associated myopathy, indicating systemic inflammatory disease with muscle involvement. Knee RA can severely impact mobility and weight-bearing activities, while concurrent myopathy adds complexity to treatment and rehabilitation planning.
Documentation Requirements
- ✓Confirmed rheumatoid arthritis diagnosis with established clinical criteria
- ✓Specific documentation of right knee joint involvement
- ✓Clinical evidence of myopathy with muscle weakness or dysfunction
- ✓Joint examination findings consistent with inflammatory arthritis
- ✓Assessment of knee function and weight-bearing capacity
- ✓Documentation of muscle weakness beyond joint limitation
- ✓Comprehensive treatment approach for both conditions
Commonly Confused Codes
M05.462 — Rheumatoid myopathy with RA of left knee (different laterality)M05.469 — Rheumatoid myopathy with RA of unspecified knee (when laterality unknown)M06.861 — Other specified rheumatoid arthritis, right knee (lacks myopathy)M17.11 — Unilateral primary osteoarthritis, right knee (different arthritis type)G72.9 — Myopathy, unspecified (lacks RA component)
Code Hierarchy
└M05Rheumatoid arthritis with rheumatoid factor└M05.4Rheumatoid myopathy with rheumatoid arthritis└M05.46Rheumatoid myopathy with rheumatoid arthritis of knee└M05.461Rheumatoid myopathy with rheumatoid arthritis of right knee
└M05.461Rheumatoid myopathy with rheumatoid arthritis of right knee