M05.511

Billable

Rheumatoid polyneuropathy with rheumatoid arthritis of right shoulder

HCC Category Mapping

V28HCC 93 — Rheumatoid Arthritis and Inflammatory Connective Tissue Disease

0.175

What This Code Means

Nerve damage affecting multiple nerves (polyneuropathy) caused by rheumatoid arthritis of the right shoulder.

Coding Tips

•Verify documentation confirms RIGHT shoulder involvement and polyneuropathy as a complication
•Polyneuropathy must be documented as related to the rheumatoid arthritis disease process

Clinical Significance

This diagnosis indicates rheumatoid arthritis of the right shoulder with polyneuropathy, representing severe systemic disease with neurological complications. Shoulder RA significantly impacts upper extremity function and activities of daily living, while polyneuropathy adds neurological complexity requiring specialized care.

Documentation Requirements

✓Confirmed rheumatoid arthritis diagnosis with established criteria
✓Specific documentation of right shoulder joint involvement
✓Clinical evidence of polyneuropathy with multiple nerve involvement
✓Neurological examination demonstrating sensory or motor deficits
✓Assessment of shoulder function and range of motion
✓Laboratory or imaging studies supporting inflammatory arthritis
✓Treatment plan addressing both shoulder arthritis and neuropathy

Commonly Confused Codes

M05.512 — Rheumatoid polyneuropathy with RA of left shoulder (different laterality)M05.519 — Rheumatoid polyneuropathy with RA of unspecified shoulder (when laterality unknown)M06.811 — Other specified rheumatoid arthritis, right shoulder (lacks polyneuropathy)G62.9 — Polyneuropathy, unspecified (lacks RA component)M25.511 — Pain in right shoulder (symptom only)

Code Hierarchy

└M05Rheumatoid arthritis with rheumatoid factor └M05.5Rheumatoid polyneuropathy with rheumatoid arthritis └M05.51Rheumatoid polyneuropathy with rheumatoid arthritis of shoulder └M05.511Rheumatoid polyneuropathy with rheumatoid arthritis of right shoulder

└M05.511Rheumatoid polyneuropathy with rheumatoid arthritis of right shoulder