M08.29

Billable

Juvenile rheumatoid arthritis with systemic onset, multiple sites

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 with systemic symptoms that affects multiple joints throughout the body simultaneously.

Coding Tips

•Use this code when systemic onset JRA involves three or more joint sites
•Document all affected sites in the medical record for comprehensive clinical documentation

Clinical Significance

Juvenile rheumatoid arthritis with systemic onset affecting multiple sites represents the most severe form of childhood arthritis requiring intensive multidisciplinary management. This polyarticular presentation with systemic features indicates high disease activity, significant functional impairment, and increased risk for growth abnormalities and joint destruction requiring aggressive immunosuppressive therapy.

Documentation Requirements

✓Patient age at onset (must be under 16 years)
✓Evidence of systemic symptoms (fever, rash, lymphadenopathy, hepatosplenomegaly)
✓Documentation of multiple joint involvement (typically 5 or more joints)
✓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 multiple joint swelling, warmth, or limited motion
✓Assessment of functional impact across multiple body systems

Commonly Confused Codes

M08.3 — Juvenile rheumatoid polyarthritis seronegative (multiple joints but without systemic symptoms)M08.20 — Juvenile rheumatoid arthritis with systemic onset, unspecified site (when specific multiple sites not documented)M06.9 — Rheumatoid arthritis, unspecified (for adult-onset rheumatoid arthritis)M35.9 — Systemic connective tissue disorder, unspecified (broader category of systemic diseases)L93.0 — Discoid lupus erythematosus (may have similar systemic features)

Code Hierarchy

└M08Juvenile arthritis └M08.2Juvenile rheumatoid arthritis with systemic onset └M08.29Juvenile rheumatoid arthritis with systemic onset, multiple sites

└M08.29Juvenile rheumatoid arthritis with systemic onset, multiple sites