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M12.359

Billable

Palindromic rheumatism, unspecified hip

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

A type of arthritis causing recurring episodes of joint pain and swelling in the hip when the specific side (left or right) is not documented or is bilateral.

Coding Tips

  • •Use code 9 (unspecified) only when documentation does not clearly specify which hip is affected
  • •Query the provider if possible to determine laterality and assign a more specific code (M12.351 or M12.352)

Code Hierarchy

└M12Other and unspecified arthropathy└M12.3Palindromic rheumatism└M12.35Palindromic rheumatism, hip└M12.359Palindromic rheumatism, unspecified hip
└M12.359Palindromic rheumatism, unspecified hip

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