M08.261
BillableJuvenile rheumatoid arthritis with systemic onset, right knee
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 type of childhood arthritis that affects the right knee and causes inflammation throughout the body, including fever and rash.
Coding Tips
- •Confirm right knee is documented in the clinical assessment
- •Note any effusion, swelling, or range of motion limitations specific to the right knee
Clinical Significance
Juvenile rheumatoid arthritis with systemic onset represents a severe form of childhood arthritis with significant systemic inflammation requiring intensive management. Knee involvement is common in JRA and can lead to significant functional limitations, growth disturbances, and the need for ongoing physical therapy and disease-modifying treatments.
Documentation Requirements
- ✓Patient age at onset (must be under 16 years)
- ✓Evidence of systemic symptoms (fever, rash, lymphadenopathy, hepatosplenomegaly)
- ✓Documentation of right knee joint involvement with inflammation
- ✓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 knee joint swelling, warmth, or effusion
- ✓Assessment of functional impact including mobility and ambulation
Commonly Confused Codes
M08.20 — Juvenile rheumatoid arthritis with systemic onset, unspecified site (use when specific joint not documented)M08.3 — Juvenile rheumatoid polyarthritis seronegative (affects multiple joints without systemic symptoms)M25.561 — Pain in right knee (symptom code, not diagnostic)M23.91 — Other internal derangement of right knee (mechanical problems, not inflammatory)M24.66 — Ankylosis, right knee (end-stage joint changes, different code category)
Code Hierarchy
└M08Juvenile arthritis└M08.2Juvenile rheumatoid arthritis with systemic onset└M08.26Juvenile rheumatoid arthritis with systemic onset, knee└M08.261Juvenile rheumatoid arthritis with systemic onset, right knee
└M08.261Juvenile rheumatoid arthritis with systemic onset, right knee