M06.859
BillableOther specified rheumatoid arthritis, unspecified hip
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 form of rheumatoid arthritis affecting the hip joint when the specific side (left or right) is not documented or is bilateral.
Coding Tips
- •Use this code only when laterality cannot be determined from the medical record
- •Query the provider if documentation indicates bilateral hip involvement to determine if separate codes are needed
Clinical Significance
Other specified rheumatoid arthritis of unspecified hip indicates an atypical RA variant affecting a major weight-bearing joint when laterality is not documented or bilateral involvement exists. Hip arthritis significantly impacts mobility, ambulation, and functional independence.
Documentation Requirements
- ✓Confirmed rheumatoid arthritis diagnosis with specific atypical characteristics
- ✓Documentation of hip involvement without laterality specification
- ✓Clinical features that distinguish this as 'other specified' RA type
- ✓Assessment of hip function and weight-bearing limitations
- ✓Laboratory support for active rheumatoid inflammatory process
- ✓Evidence that laterality is truly unspecified or bilateral involvement
- ✓Functional evaluation of mobility and ambulation capacity
- ✓Treatment plan addressing both inflammatory control and functional mobility
Commonly Confused Codes
M06.851 — Other specified rheumatoid arthritis, right hip (when laterality is documented)M06.852 — Other specified rheumatoid arthritis, left hip (when laterality is documented)M06.80 — Other specified rheumatoid arthritis, unspecified site (when hip location documented)M05.859 — Other rheumatoid arthritis with rheumatoid factor of unspecified hip (different RA classification)M25.559 — Pain in unspecified hip (symptom without inflammatory diagnosis)
Code Hierarchy
└M06Other rheumatoid arthritis└M06.8Other specified rheumatoid arthritis└M06.85Other specified rheumatoid arthritis, hip└M06.859Other specified rheumatoid arthritis, unspecified hip
└M06.859Other specified rheumatoid arthritis, unspecified hip