2026 ICD-10-CM Diagnosis Code L40.54Psoriatic juvenile arthropathy

ICD-10-CM Codes›L00–L99›L40-L45›L40

ICD-10-CM L40.54
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

L40.54 is a billable ICD-10-CM diagnosis code for psoriatic juvenile arthropathy. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 545 through 547. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Other specified chronic arthropathy and Other specified inflammatory condition of skin.

For Medicare Advantage risk adjustment, L40.54 maps to CMS-HCC Category 93 (Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders) under the V28 model, adding a risk factor of about 0.617 for a community, non-dual, aged beneficiary in payment year 2026.

Code Identity

ICD-10-CM Code
L40.54
Billable Status
Yes — Valid for Submission
Code Describes
Psoriatic juvenile arthropathy
Short Description
Psoriatic juvenile arthropathy
Same as the full description in the CMS dataset.
Parent Code
L40.5
Arthropathic psoriasis

Code Classification

ChapterL00–L99Diseases of the skin and subcutaneous tissue
SectionL40-L45Papulosquamous disorders
CategoryL40Psoriasis
This CodeL40.54Psoriatic juvenile arthropathy

Medicare Risk Adjustment (HCC)Billing

L40.54 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2026.

CMS-HCC V28 Category (Payment Model)
HCC 93— Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders
Payment HCC · PY 2026 one of 508 ICD-10-CM codes in this category
Risk Adjustment Factor (RAF) Weight
+0.617
community, non-dual, aged · ranges 0.288–0.617 across segments
Hierarchy
Supersedes HCC 94
less severe related categories are not paid alongside HCC 93
Prior Model (CMS-HCC V24)
HCC 40
V24 retired V28 pays 100% of MA risk scores since PY 2026
Other CMS Models
PACE (CMS-HCC V22): HCC 40 · ESRD (V21): HCC 40 · ESRD (V24): HCC 40
ESRD V21 weights: 0.072 dialysis, 0.274–0.398 functioning graft · ESRD V24 weights: 0.058 dialysis, 0.284–0.414 functioning graft
Part D (RxHCC)
RxHCC 81 — Psoriatic Arthropathy
also risk-adjusts in the Part D prescription drug model (V08)

Source: CMS Payment Year 2026 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Iritis with psoriatic arthritis
  • Juvenile psoriatic arthritis
  • Juvenile psoriatic arthritis with psoriasis
  • Oligoarticular joint involvement
  • Oligoarticular psoriatic arthritis
  • Polyarticular psoriatic arthritis
  • Psoriatic arthritis

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR MUS005
Other specified chronic arthropathy
Default principal diagnosis: inpatient No · outpatient No
CCSR SKN002
Other specified inflammatory condition of skin
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Psoriatic Arthritis

Psoriasis is a skin disease that causes itchy or sore patches of thick, red skin with silvery scales. You usually get them on your elbows, knees, scalp, back, face, palms and feet, but they can show up on other parts of your body.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert L40.54 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
696.0 Psoriatic arthropathy
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About L40.54Overview

What is the ICD-10 code for psoriatic juvenile arthropathy?

The ICD-10-CM code for psoriatic juvenile arthropathy is L40.54 (sometimes written as L4054). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

Is L40.54 (Arthropathic psoriasis) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report psoriatic juvenile arthropathy on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does L40.54 group to?

When psoriatic juvenile arthropathy is the principal diagnosis on an inpatient stay, it groups to MS-DRG 545, 546, 547, with relative weights from 0.8362 to 2.4817 depending on complications. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of L40.54?

Under the General Equivalence Mappings, psoriatic juvenile arthropathy converts to ICD-9-CM 696.0 (psoriatic arthropathy). The mapping is approximate, so confirm the match fits the documentation.

What HCC is L40.54?

L40.54 (psoriatic juvenile arthropathy) maps to CMS-HCC Category 93 (Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders), commonly written as HCC 93, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2026. It mapped to HCC 40 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. In the Part D prescription drug model it maps to RxHCC 81.

Does L40.54 risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, L40.54 adds a risk adjustment factor of about 0.617 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.288 to 0.617 depending on the payment segment). HCC 93 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 93 category page.