Wiki M05.9 vs M06.4

[brandileia@gmail.com]

M05.9: Rheumatoid arthritis with rheumatoid factor, unspecified vs M06.4: Inflammatory polyarthropathy. I am not sure what is correct. Are we able to code both at the same time or do we remove the unspecified code? I feel like I am coding the same issue twice & as part of our coding guidelines we should not be coding the same condition twice. Anyone have a better understanding of this condition & coding it to provide more information for understanding?

 

[sls314]

M05.9: Rheumatoid arthritis with rheumatoid factor, unspecified vs M06.4: Inflammatory polyarthropathy. I am not sure what is correct. Are we able to code both at the same time or do we remove the unspecified code? I feel like I am coding the same issue twice & as part of our coding guidelines we should not be coding the same condition twice. Anyone have a better understanding of this condition & coding it to provide more information for understanding?

There's a coding clinic reference from 1st Quarter 2024 that might be helpful.

Since the M06 category is "other rheumatoid arthritis," it says to use the M06.4 code because it is more specific than rheumatoid arthritis unspecified.

The coding clinic example used M06.9 vs M05.9, but the rationale of specificity may still be applicable?

(I'm not a rheumatology coder - I just noticed there was a recent coding clinic update under M06.4 and looked up the info for you.)