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M08.272 ICD-10-CM Code: Juvenile rheumatoid arthritis with systemic onset, left ankle and foot

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FY 2026 Apr update / Diseases of the musculoskeletal system and connective tissue (M00-M99) / Inflammatory polyarthropathies (M05-M14)

M08.272

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Juvenile rheumatoid arthritis with systemic onset, left ankle and foot

A type of childhood arthritis with systemic symptoms that primarily involves the left ankle and foot joints.

Buddy the Bee presenting code insight

Buddy Insight

Juvenile rheumatoid arthritis with systemic onset represents a severe form of childhood arthritis with significant systemic inflammation requiring intensive management.

CMS-HCC V28

HCC 93

RAF 0.175

CMS-HCC V24

HCC 40

RAF 0.307

ACA/HHS

0

0

RAF 0

ESRD/PACE

HCC 40

RAF 0.0

RXHCC

HCC 83

RAF 0.0

Code Trumping

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Code Book Path

Official
M08.2Juvenile rheumatoid arthritis with systemic onset
M08.27Juvenile rheumatoid arthritis with systemic onset, ankle and foot
M08.272Juvenile rheumatoid arthritis with systemic onset, left ankle and foot

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for M08.272 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for M08.272 in this effective period.

Related Child Codes

Official
M08.271Juvenile rheumatoid arthritis with systemic onset, right ankle and foot
M08.279Juvenile rheumatoid arthritis with systemic onset, unspecified ankle and foot

Includes

Official

ICD-10-CM does not list Includes notes for M08.272 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for M08.272 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for M08.272 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for M08.272 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for M08.272 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Patient age at onset (must be under 16 years)
Evidence of systemic symptoms (fever, rash, lymphadenopathy, hepatosplenomegaly)
Documentation of left ankle and foot joint involvement with inflammation
Laboratory evidence of systemic inflammation (elevated ESR, CRP)

MEAT Support

HCC Buddy guidance
Patient age at onset (must be under 16 years)
Evidence of systemic symptoms (fever, rash, lymphadenopathy, hepatosplenomegaly)
Documentation of left ankle and foot joint involvement with inflammation
Laboratory evidence of systemic inflammation (elevated ESR, CRP)

Audit Caution

HCC Buddy guidance
Coding adult rheumatoid arthritis codes when patient had juvenile onset
Using unspecified site codes when specific ankle/foot involvement is documented
Failing to distinguish between systemic onset JRA and other JRA subtypes
Missing the requirement for laterality specification in ankle/foot involvement

Common Mistakes

HCC Buddy guidance
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)
M25.572 — Pain in left ankle and joints of left foot (symptom code, not diagnostic)
M21.62 — Acquired deformities of left foot (structural changes, not inflammatory process)

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 M08.272 an HCC code?

Yes. M08.272 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

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

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 M08.272

For M08.272to 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 M08.272 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

M08.272 is the ICD-10-CM diagnosis code for juvenile rheumatoid arthritis with systemic onset, left ankle and foot. A type of childhood arthritis with systemic symptoms that primarily involves the left ankle and foot joints. M08.272 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, M08.272 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, M08.272 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.

Ensure laterality is documented as left before assigning this code. Because M08.272 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 M08.272 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Ensure laterality is documented as left before assigning this code
  • Review for systemic manifestations (fever, rash, hepatosplenomegaly) to confirm systemic onset subtype

Clinical Significance

Juvenile rheumatoid arthritis with systemic onset represents a severe form of childhood arthritis with significant systemic inflammation requiring intensive management. Ankle and foot involvement can significantly impact mobility, growth, and development, requiring comprehensive orthopedic and rheumatologic care with potential for long-term disability.

Documentation Requirements

  • Patient age at onset (must be under 16 years)
  • Evidence of systemic symptoms (fever, rash, lymphadenopathy, hepatosplenomegaly)
  • Documentation of left ankle and foot 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 ankle/foot swelling, warmth, or limited motion
  • Assessment of functional impact including gait and weight-bearing capacity

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)
  • M25.572: Pain in left ankle and joints of left foot (symptom code, not diagnostic)
  • M21.62: Acquired deformities of left foot (structural changes, not inflammatory process)
  • S93.402A: Sprain of unspecified ligament of left ankle, initial encounter (traumatic injury)

Child Codes

Code Hierarchy

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