M05.619
BillableRheumatoid arthritis of unspecified shoulder with involvement of other organs and systems
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 affecting an unspecified shoulder with systemic complications involving other organs such as the heart, lungs, or blood vessels.
Coding Tips
- •Use this code only when the specific shoulder (right or left) is not documented; query provider for laterality when possible
- •Confirm presence of systemic organ involvement beyond the joint to justify this code assignment
Clinical Significance
Indicates rheumatoid arthritis of unspecified shoulder with involvement of other organs and systems, representing severe systemic inflammatory disease with extra-articular manifestations. This diagnosis reflects complex RA with multi-organ involvement requiring intensive medical management and monitoring.
Documentation Requirements
- ✓Confirmed rheumatoid arthritis diagnosis meeting clinical criteria
- ✓Shoulder joint involvement without laterality specification
- ✓Documentation of extra-articular organ system involvement
- ✓Evidence of systemic manifestations beyond joint disease
- ✓Laboratory evidence of systemic inflammation and disease activity
- ✓Specialist evaluations documenting multi-organ involvement
- ✓Assessment of functional status and disability level
- ✓Physician documentation linking RA to systemic complications
Commonly Confused Codes
M05.611 — Use when right shoulder is specifically documentedM05.612 — Use when left shoulder is specifically documentedM19.019 — Shoulder osteoarthritis without rheumatoid componentM06.819 — Other RA of unspecified shoulder without organ involvementM75.30 — Calcific tendinitis of unspecified shoulder without RA
Code Hierarchy
└M05Rheumatoid arthritis with rheumatoid factor└M05.6Rheumatoid arthritis with involvement of other organs and systems└M05.61Rheumatoid arthritis of shoulder with involvement of other organs and systems└M05.619Rheumatoid arthritis of unspecified shoulder with involvement of other organs and systems
└M05.619Rheumatoid arthritis of unspecified shoulder with involvement of other organs and systems