M05.312 Rheumatoid heart disease with rheumatoid arthritis of left shoulder

Billable ICD-10-CM code, FY2026.

Applies from M05 Rheumatoid arthritis with rheumatoid factor

Excludes1 (never code together)

• rheumatic fever (I00)
• juvenile rheumatoid arthritis (M08.-)
• rheumatoid arthritis of spine (M45.-)

Applies from M05.3 Rheumatoid heart disease with rheumatoid arthritis

Applicable to

• Rheumatoid carditis
• Rheumatoid endocarditis
• Rheumatoid myocarditis
• Rheumatoid pericarditis

Risk adjustment (HCC)

• CMS-HCC V28: HCC 93 — Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders
• CMS-HCC V22: HCC 40 — Rheumatoid Arthritis and Inflammatory Connective Tissue Disease
• RxHCC V08: HCC 83 — Rheumatoid Arthritis and Other Inflammatory Polyarthropathy
• ESRD V24: HCC 40

MS-DRG index

Defines the logic of DRG(s) 545-547 in MDC 08.

Approximate ICD-9-CM (GEMs)

• 714.2 Other rheumatoid arthritis with visceral or systemic involvement (approximate)

Code annotations containing back-references to M05.312

Back-references to M05.31

• Type 1 Excludes: I09.9 Rheumatic heart disease, unspecified ("rheumatoid carditis (M05.31)")
• Type 1 Excludes: I32 Pericarditis in diseases classified elsewhere ("rheumatoid (arthritis) (M05.31)")
• Type 1 Excludes: I39 Endocarditis and heart valve disorders in diseases classified elsewhere ("rheumatoid arthritis (M05.31)")
• Type 1 Excludes: I41 Myocarditis in diseases classified elsewhere ("rheumatoid arthritis (M05.31)")
• Type 1 Excludes: I52 Other heart disorders in diseases classified elsewhere ("rheumatoid arthritis (M05.31)")

Back-references to M05

• Code Also: I27.21 Secondary pulmonary arterial hypertension ("rheumatoid arthritis (M05.-)")
• Type 1 Excludes: R76.81 Abnormal rheumatoid factor and anti-citrullinated protein antibody without rheumatoid arthritis ("rheumatoid arthritis with rheumatoid factor (M05.-)")

Nearby codes

• M05.29 Rheumatoid vasculitis with rheumatoid arthritis of multiple sites
• M05.3 Rheumatoid heart disease with rheumatoid arthritis
• M05.30 Rheumatoid heart disease with rheumatoid arthritis of unspecified site
• M05.31 Rheumatoid heart disease with rheumatoid arthritis of shoulder
• M05.311 Rheumatoid heart disease with rheumatoid arthritis of right shoulder
• M05.312 Rheumatoid heart disease with rheumatoid arthritis of left shoulder (this code)
• M05.319 Rheumatoid heart disease with rheumatoid arthritis of unspecified shoulder
• M05.32 Rheumatoid heart disease with rheumatoid arthritis of elbow
• M05.321 Rheumatoid heart disease with rheumatoid arthritis of right elbow
• M05.322 Rheumatoid heart disease with rheumatoid arthritis of left elbow
• M05.329 Rheumatoid heart disease with rheumatoid arthritis of unspecified elbow