ICD Code M06.4

ICD code M06.4 is used to identify inflammatory polyarthropathy, a condition characterized by inflammation affecting multiple joints in the body. This code is part of the International Classification of Diseases (ICD) system, which is used by healthcare providers to classify and code all diagnoses, symptoms, and procedures. Inflammatory polyarthropathy can lead to joint pain, swelling, and stiffness, and it often requires comprehensive management to alleviate symptoms and prevent joint damage.

When considering the use of the ICD code for inflammatory polyarthropathy, healthcare providers should evaluate the following diagnostic criteria and symptoms:

1. Presence of Joint Inflammation: Confirmed inflammation in multiple joints, characterized by swelling, redness, warmth, and pain.

2. Symmetrical Joint Involvement: Symptoms typically affect the same joints on both sides of the body, such as both wrists or both knees.

3. Duration of Symptoms: Persistent symptoms lasting for more than six weeks, indicating a chronic condition rather than an acute episode.

4. Morning Stiffness: Patients often experience stiffness in the joints upon waking, lasting for at least 30 minutes.

5. Systemic Symptoms: Accompanying systemic symptoms such as fatigue, fever, or weight loss may be present.

6. Exclusion of Other Conditions: Rule out other potential causes of polyarthropathy, such as infections, metabolic disorders, or other autoimmune diseases.

7. Laboratory Findings: Supportive laboratory tests may include elevated inflammatory markers like ESR (erythrocyte sedimentation rate) or CRP (C-reactive protein).

8. Radiographic Evidence: Imaging studies may show joint space narrowing, erosions, or other changes consistent with inflammatory arthritis.

9. Response to Treatment: Consideration of the patient's response to anti-inflammatory or disease-modifying treatments, which may support the diagnosis.

By systematically evaluating these criteria, healthcare providers can accurately determine when to use the ICD code for inflammatory polyarthropathy in their documentation and billing processes.

For the ICD code M06.4, which pertains to inflammatory polyarthropathy, the relevant CPT codes that may be applicable for treatment include:

1. 99201-99205: New patient office or other outpatient visit codes, depending on the complexity and time spent.

2. 99211-99215: Established patient office or other outpatient visit codes, depending on the complexity and time spent.

3. 20610: Arthrocentesis, aspiration, and/or injection into a major joint or bursa (e.g., knee, hip, shoulder joint).

4. 20611: Arthrocentesis, aspiration, and/or injection into a major joint or bursa with ultrasound guidance.

5. 96372: Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular.

6. J3301: Injection, triamcinolone acetonide, not otherwise specified, 10 mg (for corticosteroid injections).

7. J1020: Injection, methylprednisolone acetate, 20 mg (for corticosteroid injections).

8. J1030: Injection, methylprednisolone acetate, 40 mg (for corticosteroid injections).

9. J1040: Injection, methylprednisolone acetate, 80 mg (for corticosteroid injections).

These CPT codes are examples of procedures and services that might be used in the management and treatment of conditions associated with ICD code M06.4. It is important for healthcare providers to select the appropriate CPT codes based on the specific services rendered and the clinical scenario.

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