M08.259

Billable

Juvenile rheumatoid arthritis with systemic onset, unspecified hip

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 type of childhood arthritis affecting the hip with systemic symptoms when the specific side (left or right) is not documented or both sides are involved.

Coding Tips

•Use only when hip laterality is unclear or bilateral involvement is present
•Query provider to determine if one or both hips are affected for appropriate code selection

Clinical Significance

Juvenile rheumatoid arthritis with systemic onset represents a severe form of childhood arthritis with significant systemic inflammation requiring intensive management. Hip involvement in JRA is particularly concerning due to potential for growth disturbances and significant functional impairment requiring aggressive treatment.

Documentation Requirements

✓Patient age at onset (must be under 16 years)
✓Evidence of systemic symptoms (fever, rash, lymphadenopathy, hepatosplenomegaly)
✓Documentation of hip joint involvement without laterality specification or bilateral involvement
✓Laboratory evidence of systemic inflammation (elevated ESR, CRP)
✓Exclusion of other causes of arthritis and systemic illness
✓Duration of symptoms (minimum 6 weeks for JRA diagnosis)
✓Physical examination findings of hip joint limitation, pain, or swelling
✓Assessment of functional impact including gait abnormalities

Commonly Confused Codes

M08.251 — Use when right hip specifically documented M08.252 — Use when left hip specifically documented M08.3 — Juvenile rheumatoid polyarthritis seronegative (affects multiple joints without systemic symptoms)M25.559 — Pain in unspecified hip (symptom code, not diagnostic)M91.90 — Juvenile osteochondrosis of hip and pelvis, unspecified (different pathophysiology)

Code Hierarchy

└M08Juvenile arthritis └M08.2Juvenile rheumatoid arthritis with systemic onset └M08.25Juvenile rheumatoid arthritis with systemic onset, hip └M08.259Juvenile rheumatoid arthritis with systemic onset, unspecified hip

└M08.259Juvenile rheumatoid arthritis with systemic onset, unspecified hip