M06.369

Billable

Rheumatoid nodule, unspecified knee

HCC Category Mapping

V28HCC 93 — Rheumatoid Arthritis and Inflammatory Connective Tissue Disease

0.175

V24HCC 40 — Rheumatoid Arthritis and Inflammatory Connective Tissue Disease

0.307

ESRDHCC 40 — Rheumatoid Arthritis and Inflammatory Connective Tissue Disease

0.000

RxHCCHCC 83 — Rheumatoid Arthritis and Inflammatory Connective Tissue Disease

0.000

What This Code Means

A firm, non-cancerous nodule associated with rheumatoid arthritis that develops in or around the knee joint, but the specific knee is not specified.

Coding Tips

•Use this code when the rheumatoid nodule location is documented as knee but laterality (left/right) is not specified or documented as unspecified
•Rheumatoid nodules are characteristic extra-articular manifestations of rheumatoid arthritis and should be coded in addition to the primary RA diagnosis

Clinical Significance

Rheumatoid nodules affecting an unspecified knee location indicate active, severe rheumatoid arthritis requiring careful monitoring and aggressive treatment. The presence of nodules suggests seropositive disease with increased risk for joint damage and systemic complications.

Documentation Requirements

✓Confirmed rheumatoid arthritis diagnosis meeting classification criteria
✓Clinical examination documenting rheumatoid nodule presence
✓Location specified as knee but laterality not documented or bilateral
✓Nodule characteristics described (firm, non-tender, subcutaneous)
✓Laboratory evidence supporting rheumatoid arthritis diagnosis
✓Functional assessment of affected knee joint
✓Treatment response and management strategy documented
✓Differentiation from other knee pathology or nodular conditions

Commonly Confused Codes

M06.361 — Rheumatoid nodule, right knee (when laterality is actually documented)M06.362 — Rheumatoid nodule, left knee (when laterality is actually documented)M06.30 — Rheumatoid nodule, unspecified site (when knee location is documented)M25.569 — Pain in unspecified knee (symptom without nodule)M79.3 — Panniculitis, unspecified (non-rheumatoid nodule)

Code Hierarchy

└M06Other rheumatoid arthritis └M06.3Rheumatoid nodule └M06.36Rheumatoid nodule, knee └M06.369Rheumatoid nodule, unspecified knee

└M06.369Rheumatoid nodule, unspecified knee