Medicare Risk Adjustment Coding Focus

Volume 5, Issue 11, November 2018

condition can also damage other body involvement. The medical record needs systems such as the blood vessels, eyes, to clearly indicate the rheumatoid heart, nerves and skin.2 arthritis type, location, and/or associated complications (if present) in order to Risk Factors code to the highest degree of specificity.4 Rheumatoid arthritis can occur at any age but onset typically happens among Other Rheumatoid Arthritis without people in their sixties. Smoking, inherited traits and obesity can increase Rheumatoid Factor Overview a person’s risk of developing rheumatoid (HCC 40)

arthritis and can make the effects of the Rheumatoid arthritis (RA) is a systemic disease worse.3 M06.00 – Unspecified Site autoimmune disease that occurs when M06.01* – Shoulder the body’s immune system mistakenly Treatment M06.02* – Elbow attacks its own tissue and joints. Chronic M06.03* – Wrist inflammation causes the tissue that lines The goal for treatment is to slow or stop M06.04* – Hand the inside of the joints, called the the progression of the disease and M06.05* – Hip synovium, to thicken. The synovium damage to the joints. The earlier the M06.06* – Knee makes a fluid that lubricates the joints symptoms of this disease are diagnosed, M06.07* – Ankle and foot and helps them to move smoothly. A lack the earlier treatment can begin to M06.08 – Vertabrae of this fluid will result in pain and control the inflammation and reduce M06.09 – Multiple Sites swelling around the joints and, over damaging effects such as: time, lead to atrophy and a loss in bone  NSAIDs are prescribed to ease *requires additional characters to density. arthritis pain and inflammation indicate laterality

 Corticosteroids are utilized to .__1 – right More than 1.5 million people in the get the inflammation under .__2 – left United States have been diagnosed with control during a flare .__9 – unspecified rheumatoid arthritis and the rate of  Biologics administered by occurrence is higher among women than injection or infusion may be Resources: men.1 used when other medications

are not effective Signs and Symptoms 1 Arthritis Foundation (n.d.). What is  Joint replacement is another Rheumatoid Arthritis? Accessed October 25, treatment option when there is The symptoms and effects of rheumatoid 2018, from arthritis.org permanent damage to areas arthritis can come and go and a flare in 2 Cleveland Clinic (2017). Rheumatoid such as ankles, hips, knees or the disease can last for days or even Arthritis. Accessed October 26, 2018, from months. Rheumatoid arthritis causes shoulders. clevelandclinic.org deformity, pain, stiffness and swelling of 3 Coding Guidance Centers for Disease Control and Prevention the joints. Patients have also reported (2017). Rheumatoid Arthritis (RA). Accessed fatigue, fever, weakness and weight loss Diagnosis codes for rheumatoid arthritis October 26, 2018, from cdc.gov with rheumatoid arthritis. 4 are located in chapter 13 of the ICD-10- Schmidt, A., & Patterson, L. (2018). ICD-10-

CM codebook. These codes contain CM Professional for Physicians. Salt Lake City: The disease is more common in the feet, detail that indicate the anatomical site, OPTUM360. hands, knees and wrists but can affect including laterality, along with any organ any joint. For some people, this In New Mexico, Amerigroup Community Care of New Mexico, Inc. In Texas, Amerigroup members in the Medicaid Rural Service Area are served by Amerigroup Insurance Company; all other Amerigroup members are served by Amerigroup Texas, Inc. In Washington, Amerigroup Washington, Inc. Amerivantage is a DSNP plan with a Medicare contract and a contract with the State Medicaid program. In New Mexico: Amerivantage is an HMO with a Medicare contract. Enrollment in Amerivantage depends on contract renewal. Y0114_18_37727_I_11/13/2018