ICD Code L40.52

ICD code L40.52 is psoriatic arthritis mutilans, a severe and destructive form of psoriatic arthritis that leads to joint damage and deformity.

1. Presence of a chronic inflammatory arthritis associated with psoriasis

2. Severe joint destruction and deformity, often affecting the hands and feet

3. Marked osteolysis leading to telescoping of digits (opera glass hand)

4. Radiographic evidence of bone resorption and joint collapse

5. History or clinical evidence of psoriatic skin or nail changes

6. Absence of rheumatoid factor (seronegative for RF)

7. Rapid progression of joint damage despite therapy

Relevant CPT codes that may be used to treat ICD code L40.52 include:

- 20610: Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., shoulder, hip, knee joint, subacromial bursa)

- 20611: Arthrocentesis, aspiration and/or injection, major joint or bursa with ultrasound guidance

- 29820: Arthroscopy, shoulder, surgical; synovectomy, partial

- 29821: Arthroscopy, shoulder, surgical; synovectomy, complete

- 29823: Arthroscopy, shoulder, surgical; debridement, extensive

- 29881: Arthroscopy, knee, surgical; with meniscectomy (medial or lateral including any meniscal shaving)

- 29877: Arthroscopy, knee, surgical; debridement/shaving of articular cartilage

- 99213–99215: Office or other outpatient visit, established patient (for ongoing management)

- 96372: Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular

- 96401–96402: Chemotherapy administration, subcutaneous or intramuscular (if applicable for biologic agents)

- J1745: Injection, infliximab, 10 mg (for biologic therapy)

- J0129: Injection, abatacept, 10 mg

- J1602: Injection, golimumab, 1 mg

CPT code selection should be based on the specific treatment rendered for L40.52.

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