Version 2024

2024 ICD-10-CM Diagnosis Code M05.7A

Rheumatoid arthritis with rheumatoid factor of other specified site without organ or systems involvement

ICD-10-CM Code:: M05.7A
ICD-10 Code for:: Rheu arthrit with rheu factor of oth site w/o org/sys invl
Is Billable?: Yes - Valid for Submission
Chronic Condition Indicator: ^[1]: Chronic
Code Navigator:

Code Information
Clinical Classification
Tabular List of Diseases and Injuries
Index to Diseases and Injuries References
Diagnostic Related Groups Mapping
Replacement Code
Patient Education
Other Codes Used Similar Conditions
Code History

Code Classification

Diseases of the musculoskeletal system and connective tissue
(M00–M99)
- Inflammatory polyarthropathies
  (M05-M14)
  - Rheumatoid arthritis with rheumatoid factor
    (M05)

M05.7A is a billable diagnosis code used to specify a medical diagnosis of rheumatoid arthritis with rheumatoid factor of other specified site without organ or systems involvement. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.

Clinical Classification

Clinical Category is Rheumatoid arthritis and related disease
CCSR Category Code: MUS003
Inpatient Default CCSR: Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.
Outpatient Default CCSR: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.

Index to Diseases and Injuries References

The following annotation back-references for this diagnosis code are found in the injuries and diseases index. The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10-CM code(s).

- Arthritis, arthritic (acute) (chronic) (nonpyogenic) (subacute) - M19.90
- - rheumatoid - M06.9
  - - seropositive - M05.9
    - - without organ involvement - M05.70
      - - specified site NEC - M05.7A

M05.7A is grouped with Diagnostic Related Groups - MS-DRG Mapping

Diagnostic Related Groups (DRGs) are a classification system used to group together diagnosis codes for the purpose of reimbursement and healthcare management. DRGs are used to standardize the way hospitals and other providers are paid for inpatient services. In this system patients are grouped together based on their principal diagnosis in areas referred to as Major Diagnostic Categories (MDC). Once a patient is assigned a particular diagnostic category, providers receive a predetermined payment rate for the services rendered. This reimbursement rate is often fixed and is meant to cover the cost of care for that patient. Reimbursement is also affected by the relative weight of a diagnostic related group based on the severity of a patient's illness and the associated cost of care during hospitalization.

Diagnostic related groups encourage healthcare providers to focus on quality and efficiency in patient care while managing costs effectively. The diagnosis code is present in the following groups for version MS-DRG V41.0 applicable from 10/01/2023 through 09/30/2024.

MS-DRG	MS-DRG Title	MCD	Relative Weight
545	CONNECTIVE TISSUE DISORDERS WITH MCC	08	2.4932
546	CONNECTIVE TISSUE DISORDERS WITH CC	08	1.1993
547	CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC	08	0.8134

The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.

Replacement Code

M057A replaces the following previously assigned ICD-10-CM code(s):

M05.70 - Rheu arthritis w rheu factor of unsp site w/o org/sys involv

Other ICD-10-CM Codes Commonly Used for Similar Conditions

Filter related codes list:

M05 Rheumatoid arthritis with rheumatoid factor.
M05.0 Felty's syndrome.
M05.00 Felty's syndrome, unspecified site.
M05.01 Felty's syndrome, shoulder.
M05.011 Felty's syndrome, right shoulder.
M05.012 Felty's syndrome, left shoulder.
M05.019 Felty's syndrome, unspecified shoulder.
M05.02 Felty's syndrome, elbow.
M05.021 Felty's syndrome, right elbow.
M05.022 Felty's syndrome, left elbow.
M05.029 Felty's syndrome, unspecified elbow.
M05.03 Felty's syndrome, wrist.
M05.031 Felty's syndrome, right wrist.
M05.032 Felty's syndrome, left wrist.
M05.039 Felty's syndrome, unspecified wrist.
M05.04 Felty's syndrome, hand.
M05.041 Felty's syndrome, right hand.
M05.042 Felty's syndrome, left hand.
M05.049 Felty's syndrome, unspecified hand.
M05.05 Felty's syndrome, hip.
M05.051 Felty's syndrome, right hip.
M05.052 Felty's syndrome, left hip.
M05.059 Felty's syndrome, unspecified hip.
M05.06 Felty's syndrome, knee.
M05.061 Felty's syndrome, right knee.
M05.062 Felty's syndrome, left knee.
M05.069 Felty's syndrome, unspecified knee.
M05.07 Felty's syndrome, ankle and foot.
M05.071 Felty's syndrome, right ankle and foot.
M05.072 Felty's syndrome, left ankle and foot.
M05.079 Felty's syndrome, unspecified ankle and foot.
M05.09 Felty's syndrome, multiple sites.
M05.1 Rheumatoid lung disease with rheumatoid arthritis.
M05.10 Rheumatoid lung disease with rheumatoid arthritis of unspecified site.
M05.11 Rheumatoid lung disease with rheumatoid arthritis of shoulder.
M05.111 Rheumatoid lung disease with rheumatoid arthritis of right shoulder.
M05.112 Rheumatoid lung disease with rheumatoid arthritis of left shoulder.
M05.119 Rheumatoid lung disease with rheumatoid arthritis of unspecified shoulder.
M05.12 Rheumatoid lung disease with rheumatoid arthritis of elbow.
M05.121 Rheumatoid lung disease with rheumatoid arthritis of right elbow.
M05.122 Rheumatoid lung disease with rheumatoid arthritis of left elbow.
M05.129 Rheumatoid lung disease with rheumatoid arthritis of unspecified elbow.
M05.13 Rheumatoid lung disease with rheumatoid arthritis of wrist.
M05.131 Rheumatoid lung disease with rheumatoid arthritis of right wrist.
M05.132 Rheumatoid lung disease with rheumatoid arthritis of left wrist.
M05.139 Rheumatoid lung disease with rheumatoid arthritis of unspecified wrist.
M05.14 Rheumatoid lung disease with rheumatoid arthritis of hand.
M05.141 Rheumatoid lung disease with rheumatoid arthritis of right hand.
M05.142 Rheumatoid lung disease with rheumatoid arthritis of left hand.
M05.149 Rheumatoid lung disease with rheumatoid arthritis of unspecified hand.
M05.15 Rheumatoid lung disease with rheumatoid arthritis of hip.

Code History

FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
FY 2021 - Code Added, effective from 10/1/2020 through 9/30/2021

Footnotes

[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:

The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
The condition places limitations on self-care, independent living, and social interactions.