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M06.4
ICD-10-CM
Inflammatory Polyarthropathy

Find information on Inflammatory Polyarthropathy including clinical documentation, medical coding, ICD-10 codes, diagnosis codes, symptoms, treatment, and management. Learn about healthcare best practices for Inflammatory Polyarthropathy and related arthritis conditions. Explore resources for medical professionals, clinicians, and patients seeking information on this inflammatory joint disease. This resource provides details on coding guidelines and accurate clinical documentation for Inflammatory Polyarthropathy.

Also known as

Rheumatoid Arthritis with Polyarthritis
Polyarticular Inflammatory Arthritis

Diagnosis Snapshot

Key Facts
  • Definition : Joint inflammation causing pain, swelling, and stiffness, often affecting multiple joints.
  • Clinical Signs : Swollen, tender, warm joints, limited range of motion, morning stiffness, fatigue.
  • Common Settings : Rheumatology clinics, primary care offices, physical therapy centers.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC M06.4 Coding
M05-M14

Inflammatory polyarthropathies

Covers various inflammatory joint diseases like rheumatoid arthritis.

M00-M25

Disorders of joints

Includes a broader range of joint conditions, including inflammatory types.

M30-M36

Systemic connective tissue disorders

Some connective tissue disorders can present with inflammatory polyarthritis.

M45-M49

Spondylopathies

Certain spondyloarthropathies can involve inflammatory joint manifestations.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the inflammatory polyarthropathy rheumatoid?

  • Yes

    Is it seropositive?

  • No

    Is it juvenile idiopathic arthritis?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Inflammatory joint pain, multiple joints
Rheumatoid arthritis
Psoriatic arthritis

Documentation Best Practices

Documentation Checklist
  • Document affected joint count (e.g., 2, 5, polyarticular)
  • Describe specific joint involvement (e.g., MCP, PIP, MTP)
  • Note inflammatory signs (e.g., swelling, erythema, warmth)
  • Document duration of morning stiffness
  • Specify onset pattern (acute/insidious), progression, and symmetry

Coding and Audit Risks

Common Risks
  • Unspecified Diagnosis

    Coding Inflammatory Polyarthropathy without specifying the type (e.g., Rheumatoid Arthritis) leads to inaccurate reimbursement and data analysis.

  • Comorbidity Documentation

    Insufficient documentation of comorbidities associated with Inflammatory Polyarthropathy (e.g., anemia) impacts severity and complexity coding, affecting reimbursement.

  • Laterality Neglect

    Failing to document the affected joint(s) (unilateral/bilateral) in Inflammatory Polyarthropathy leads to coding errors and inaccurate reflection of disease burden.

Mitigation Tips

Best Practices
  • Document specific joint involvement for accurate ICD-10 coding (M05-M14).
  • Ensure clear distinction between inflammatory vs non-inflammatory arthropathy for proper E/M coding.
  • Detailed history and exam findings are crucial for compliant billing and HCC risk adjustment.
  • Regularly review and update coding practices per AHA Coding Clinic guidance for compliance.
  • Use standardized terminology like SNOMED CT for consistent documentation and improved interoperability.

Clinical Decision Support

Checklist
  • 1. Morning stiffness >30min? ICD-10: M19.0 Document duration.
  • 2. Arthritis >2 joints? ICD-10: M15-M19 Specify joints.
  • 3. Elevated CRP/ESR? Document lab results, units. SNOMED: 301228009
  • 4. Symptom duration >6 weeks? ICD-10: M1A-M1Z Document onset date.

Reimbursement and Quality Metrics

Impact Summary
  • Inflammatory Polyarthropathy reimbursement hinges on accurate ICD-10 coding (M05-M14) impacting DRG assignment and payment.
  • Coding quality directly affects Case Mix Index (CMI) accuracy for hospital reporting and resource allocation.
  • Specificity in diagnosis coding (e.g., rheumatoid arthritis vs. psoriatic arthritis) influences payment and quality metrics.
  • Proper documentation of disease severity and activity level impacts reimbursement and quality scores (e.g., RAPID3).

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes for . Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Code underlying cause, not symptoms
  • Specify joint involvement for M19.0
  • Document disease activity and severity
  • Check for exclusions like RA (M05-M06)
  • Use 7th character for laterality (M19.0__)

Documentation Templates

Patient presents with inflammatory polyarthropathy, characterized by joint pain, stiffness, and swelling affecting multiple joints.  Symptoms include morning stiffness lasting greater than 30 minutes, symmetrical joint involvement, and fatigue.  Differential diagnosis includes rheumatoid arthritis, psoriatic arthritis, and other connective tissue diseases.  Physical examination reveals tenderness, warmth, and limited range of motion in affected joints.  Laboratory evaluation may include rheumatoid factor, anti-CCP antibodies, ESR, and CRP.  Imaging studies such as X-ray, ultrasound, or MRI may be indicated to assess joint damage and inflammation.  Initial treatment plan includes NSAIDs for pain relief, DMARDs such as methotrexate to slow disease progression, and corticosteroids for acute flares.  Patient education regarding disease management, exercise, and joint protection strategies is provided.  Follow-up appointment scheduled to monitor disease activity and adjust treatment as needed.  ICD-10 code M05.9, unspecified inflammatory polyarthropathy, is used for billing purposes.  Medical coding for specific medications and procedures will be documented separately.  Further evaluation may be necessary to determine the specific subtype of inflammatory polyarthropathy and optimize treatment strategies.  The patient's prognosis and functional limitations will be assessed throughout the course of treatment.
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