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M05.659

Billable

Rheumatoid arthritis of unspecified hip with involvement of other organs and systems

HCC Category Mapping

V28HCC 93Rheumatoid Arthritis and Inflammatory Connective Tissue Disease
0.175
V24HCC 40Rheumatoid Arthritis and Inflammatory Connective Tissue Disease
0.307
ESRDHCC 40Rheumatoid Arthritis and Inflammatory Connective Tissue Disease
0.000
RxHCCHCC 83Rheumatoid Arthritis and Inflammatory Connective Tissue Disease
0.000

What This Code Means

Rheumatoid arthritis affecting an unspecified hip with systemic complications involving other organs or body systems.

Coding Tips

  • Use only when hip laterality is not documented; query provider to determine if left, right, or bilateral before assigning this code.
  • Ensure systemic involvement is documented to justify the M05.6x series rather than localized arthritis codes.

Clinical Significance

This code captures systemic rheumatoid arthritis affecting an unspecified hip with organ system involvement, representing advanced inflammatory disease with significant morbidity potential. The unspecified laterality should only be used when documentation lacks specific side identification.

Documentation Requirements

  • Confirmation of rheumatoid arthritis diagnosis affecting hip joint(s)
  • Documentation that specific side (left/right) cannot be determined
  • Evidence of organ or system involvement beyond joints
  • Laboratory support for RA diagnosis (RF, anti-CCP, ESR, CRP)
  • Clinical documentation of extra-articular manifestations
  • Specific identification of affected organ systems
  • Clear relationship between systemic involvement and rheumatoid arthritis

Commonly Confused Codes

Code Hierarchy

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