M05.469 Rheumatoid myopathy with rheumatoid arthritis of unspecified knee

Billable ICD-10-CM code, FY2026. Acts as a Complication or Comorbidity (CC) as a secondary diagnosis.

Applies from M05 Rheumatoid arthritis with rheumatoid factor

Excludes1 (never code together)

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

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)

• 359.6 Symptomatic inflammatory myopathy in diseases classified elsewhere (approximate)
• 714.0 Rheumatoid arthritis (approximate)

Medicare Code Edits (MCE v43.1 (April 2026))

• Unspecified code (laterality): Unspecified codes for which a more specific code identifying laterality (right, left, bilateral) exists within the same code family.

Code annotations containing back-references to M05.469

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

• M05.452 Rheumatoid myopathy with rheumatoid arthritis of left hip
• M05.459 Rheumatoid myopathy with rheumatoid arthritis of unspecified hip
• M05.46 Rheumatoid myopathy with rheumatoid arthritis of knee
• M05.461 Rheumatoid myopathy with rheumatoid arthritis of right knee
• M05.462 Rheumatoid myopathy with rheumatoid arthritis of left knee
• M05.469 Rheumatoid myopathy with rheumatoid arthritis of unspecified knee (this code)
• M05.47 Rheumatoid myopathy with rheumatoid arthritis of ankle and foot
• M05.471 Rheumatoid myopathy with rheumatoid arthritis of right ankle and foot
• M05.472 Rheumatoid myopathy with rheumatoid arthritis of left ankle and foot
• M05.479 Rheumatoid myopathy with rheumatoid arthritis of unspecified ankle and foot
• M05.49 Rheumatoid myopathy with rheumatoid arthritis of multiple sites