M06.9

Billable

Rheumatoid arthritis, unspecified

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

Rheumatoid arthritis where the specific type or exact location is not documented or determined.

Coding Tips

•This is an unspecified code; use only when the type of rheumatoid arthritis cannot be determined from documentation
•Query the provider if more specific information about the type or location of arthritis is available

Clinical Significance

Unspecified rheumatoid arthritis represents RA where the specific type or location is not documented. This diagnosis still indicates a chronic inflammatory condition requiring long-term management and monitoring for complications.

Documentation Requirements

✓Confirmed diagnosis of rheumatoid arthritis
✓Documentation that specific type or site is unspecified
✓Clinical evidence of inflammatory arthritis
✓Laboratory confirmation of RA (RF, anti-CCP, inflammatory markers)
✓Assessment of joint involvement and function
✓Documentation of disease activity level
✓Treatment plan with anti-rheumatic medications
✓Monitoring plan for disease progression

Commonly Confused Codes

M05.9 — Unspecified seropositive RA with specific serology M13.9 — Unspecified arthritis without RA confirmation M79.9 — Unspecified soft tissue disorder M06.8[0-9] — Other specified RA when type is actually known

Code Hierarchy

└M06Other rheumatoid arthritis └M06.9Rheumatoid arthritis, unspecified

└M06.9Rheumatoid arthritis, unspecified