M08.421

Billable

Pauciarticular juvenile rheumatoid arthritis, right elbow

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 arthritis in children that affects only a few joints, specifically involving the right elbow. It causes inflammation and stiffness in the elbow joint.

Coding Tips

•Ensure the medical record clearly documents right elbow involvement before assigning this code
•Remember that pauciarticular JIA typically affects 4 or fewer joints; document which other joints may be involved

Clinical Significance

Pauciarticular juvenile rheumatoid arthritis affecting the right elbow represents a chronic inflammatory condition that can significantly impact upper extremity function and activities of daily living. This diagnosis requires ongoing rheumatologic management to prevent joint destruction, contractures, and growth abnormalities, with potential need for orthopedic intervention and rehabilitation services.

Documentation Requirements

✓Patient age at onset (must be under 16 years)
✓Involvement of 4 or fewer joints throughout disease course
✓Documentation of right elbow joint involvement with inflammation
✓Absence of systemic symptoms (fever, rash, organomegaly)
✓Duration of symptoms (minimum 6 weeks for JRA diagnosis)
✓Physical examination findings of elbow joint swelling, warmth, or limited motion
✓Laboratory studies excluding other causes of arthritis
✓Assessment of functional impact on upper extremity use and range of motion

Commonly Confused Codes

M08.3 — Juvenile rheumatoid polyarthritis seronegative (affects 5 or more joints)M08.2x — Juvenile rheumatoid arthritis with systemic onset (has systemic symptoms)M25.521 — Pain in right elbow (symptom code, not diagnostic)M24.821 — Other specific joint derangements of right elbow (mechanical problems)S53.101A — Unspecified dislocation of right radial head, initial encounter (traumatic injury)

Code Hierarchy

└M08Juvenile arthritis └M08.4Pauciarticular juvenile rheumatoid arthritis └M08.42Pauciarticular juvenile rheumatoid arthritis, elbow └M08.421Pauciarticular juvenile rheumatoid arthritis, right elbow

└M08.421Pauciarticular juvenile rheumatoid arthritis, right elbow