M08.022 ICD-10-CM Code: Unspecified juvenile rheumatoid arthritis, left elbow
HCC Buddy Code Card
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FY 2026 Apr update / Diseases of the musculoskeletal system and connective tissue (M00-M99) / Inflammatory polyarthropathies (M05-M14)
M08.022
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceUnspecified juvenile rheumatoid arthritis, left elbow
Juvenile rheumatoid arthritis affecting the left elbow in a child, where the specific type of juvenile arthritis has not been determined.
Buddy Insight
Unspecified juvenile rheumatoid arthritis of the left elbow indicates chronic inflammatory disease requiring ongoing rheumatologic management and monitoring for complications.
CMS-HCC V28
MappedHCC 93
RAF 0.175
CMS-HCC V24
MappedHCC 40
RAF 0.307
ACA/HHS
00
RAF 0
ESRD/PACE
MappedHCC 40
RAF 0.0
RXHCC
MappedHCC 83
RAF 0.0
Code Trumping
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Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for M08.022 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for M08.022 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for M08.022 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for M08.022 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for M08.022 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for M08.022 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for M08.022 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is M08.022 an HCC code?
Yes. M08.022 maps to Rheumatoid Arthritis and Inflammatory Connective Tissue Disease under the CMS-HCC V28 risk adjustment model (and Rheumatoid Arthritis and Inflammatory Connective Tissue Disease under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
MEAT Criteria for M08.022
For M08.022to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed M08.022 during that encounter, not just copy-forwarded from a problem list.
What This Code Means
M08.022 is the ICD-10-CM diagnosis code for unspecified juvenile rheumatoid arthritis, left elbow. Juvenile rheumatoid arthritis affecting the left elbow in a child, where the specific type of juvenile arthritis has not been determined. M08.022 sits in the ICD-10-CM chapter for diseases of the musculoskeletal system and connective tissue (m00-m99), within the section covering inflammatory polyarthropathies (m05-m14).
Under the CMS-HCC V28 risk adjustment model, M08.022 maps to Rheumatoid Arthritis and Inflammatory Connective Tissue Disease (HCC 93) with a community, non-dual, aged base RAF weight of 0.175. Under the older V24 model, M08.022 mapped to the same category but with a base RAF weight of 0.307, V28 recalibrated weights across the entire model. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
The '2' in the sixth position specifically indicates the left elbow; ensure documentation clearly specifies left-sided involvement. Because M08.022 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M08.022 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
Clinical Significance
Unspecified juvenile rheumatoid arthritis of the left elbow indicates chronic inflammatory disease requiring ongoing rheumatologic management and monitoring for complications. This condition significantly impacts quality of life and requires specialized pediatric rheumatology care with immunomodulating therapies.
Documentation Requirements
- ✓Patient age at disease onset under 16 years
- ✓Clinical evidence of inflammatory arthritis in left elbow
- ✓Documentation that specific juvenile arthritis subtype cannot be classified
- ✓Physical examination showing joint inflammation signs
- ✓Laboratory evidence supporting inflammatory process
- ✓Exclusion of other arthritis causes
- ✓Current treatment regimen documentation
- ✓Functional capacity assessment
Commonly Confused Codes
- •M08.021: Right elbow versus left elbow involvement
- •M08.029: Use when laterality is unspecified rather than documented left
- •M25.522: Left elbow pain versus confirmed inflammatory arthritis
- •M08.4: Pauciarticular juvenile chronic arthritis when appropriate
- •M06.9: Adult rheumatoid arthritis in patients with adult onset