M05.359 Rheumatoid heart disease with rheumatoid arthritis of unspecified hip

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 M05.359

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

• M05.342 Rheumatoid heart disease with rheumatoid arthritis of left hand
• M05.349 Rheumatoid heart disease with rheumatoid arthritis of unspecified hand
• M05.35 Rheumatoid heart disease with rheumatoid arthritis of hip
• M05.351 Rheumatoid heart disease with rheumatoid arthritis of right hip
• M05.352 Rheumatoid heart disease with rheumatoid arthritis of left hip
• M05.359 Rheumatoid heart disease with rheumatoid arthritis of unspecified hip (this code)
• M05.36 Rheumatoid heart disease with rheumatoid arthritis of knee
• M05.361 Rheumatoid heart disease with rheumatoid arthritis of right knee
• M05.362 Rheumatoid heart disease with rheumatoid arthritis of left knee
• M05.369 Rheumatoid heart disease with rheumatoid arthritis of unspecified knee
• M05.37 Rheumatoid heart disease with rheumatoid arthritis of ankle and foot