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L40.59 ICD-10-CM Code: Other psoriatic arthropathy

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Risk adjustment
CMS-HCC V28: 1 category · CMS-HCC V22 category 40 · RxHCC V08 category 81

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.

  • MS-DRG 545 — CONNECTIVE TISSUE DISORDERS WITH MCC (MDC 08)
  • MS-DRG 546 — CONNECTIVE TISSUE DISORDERS WITH CC (MDC 08)
  • MS-DRG 547 — CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC (MDC 08)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 93 — Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders (supersedes HCC 94)

Other models: CMS-HCC V22 HCC 40 · RxHCC V08 HCC 81

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Coder workflow for L40.59

MedCoder structured workflow — derived from this code’s own official record

Before you code L40.59

  1. “Other” (NEC) means the condition is specified in the record but no dedicated code captures it. Confirm the documented form is not one a sibling code names before settling on L40.59; if the record states no specifics at all, the unspecified sibling applies instead. “Other” codes are for documented conditions the classification gives no specific code; “unspecified” codes are for records lacking the detail (Guidelines I.A.9.a, I.A.9.b).

    ReviewL40.51, L40.52, L40.53, L40.54

    See the relationships section · Guide: Other vs unspecified (NEC vs NOS) →

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Any detail beyond this code’s title
What the record states that a more specific sibling code would capture — or its absence, which itself supports the unspecified code.

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Code Overview

Other psoriatic arthropathy is a billable ICD-10-CM diagnosis code (L40.59).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Indexed Clinical Terms (2)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name L40.59 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Excludes1 note: M07 — Enteropathic arthropathies (via L40.5.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 3 MS-DRGs: DRG 545 (MDC 08), DRG 546 (MDC 08), DRG 547 (MDC 08).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):SKN002 — Other specified inflammatory condition of skin (default); MUS005 — Other specified chronic arthropathy.

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders) for risk-adjusted payment.

D86.86 — Sarcoid arthropathy, D86.87 — Sarcoid myositis, G72.41 — Inclusion body myositis [IBM], I77.82 — Antineutrophilic cytoplasmic antibody [ANCA] vasculitis, L40.50 — Arthropathic psoriasis, unspecified, L40.51 — Distal interphalangeal psoriatic arthropathy, L40.52 — Psoriatic arthritis mutilans, L40.53 — Psoriatic spondylitis, L40.54 — Psoriatic juvenile arthropathy, M05.00 — Felty's syndrome, unspecified site, M05.011 — Felty's syndrome, right shoulder, M05.012 — Felty's syndrome, left shoulder, M05.019 — Felty's syndrome, unspecified shoulder, M05.021 — Felty's syndrome, right elbow, M05.022 — Felty's syndrome, left elbow, M05.029 — Felty's syndrome, unspecified elbow, M05.031 — Felty's syndrome, right wrist, M05.032 — Felty's syndrome, left wrist, M05.039 — Felty's syndrome, unspecified wrist, M05.041 — Felty's syndrome, right hand, +487 more

Related risk categories

These categories interact through CMS's HCC hierarchy — one can suppress the other's risk-adjustment weight when both are present on a claim.

Systemic Lupus Erythematosus and Other Specified Systemic Connective Tissue Disorders

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical categories (Other specified inflammatory condition of skin, Other specified chronic arthropathy).

L40.0 — Psoriasis vulgaris, L40.1 — Generalized pustular psoriasis, L40.2 — Acrodermatitis continua, L40.3 — Pustulosis palmaris et plantaris, L40.4 — Guttate psoriasis, L40.50 — Arthropathic psoriasis, unspecified, L40.51 — Distal interphalangeal psoriatic arthropathy, L40.52 — Psoriatic arthritis mutilans, L40.53 — Psoriatic spondylitis, L40.54 — Psoriatic juvenile arthropathy, L40.8 — Other psoriasis, L40.9 — Psoriasis, unspecified, L41.0 — Pityriasis lichenoides et varioliformis acuta, L41.1 — Pityriasis lichenoides chronica, L41.3 — Small plaque parapsoriasis, L41.4 — Large plaque parapsoriasis, L41.5 — Retiform parapsoriasis, L41.8 — Other parapsoriasis, L41.9 — Parapsoriasis, unspecified, L42 — Pityriasis rosea, +169 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Arthropathy”, “Psoriasis”; these codes share that main term but sit in a different category of the Tabular List.

E85.4 — Organ-limited amyloidosis (in, amyloidosis), E88.9 — Metabolic disorder, unspecified (in, metabolic disease NOS), F54 — Psychological and behavioral factors associated with disorders or diseases classified elsewhere (psychogenic), G95.0 — Syringomyelia and syringobulbia (syringomyelic), G98.0 — Neurogenic arthritis, not elsewhere classified (neuropathic, nonsyphilitic NEC), I33.0 — Acute and subacute infective endocarditis (in, infective endocarditis), J38.7 — Other diseases of larynx (cricoarytenoid), K13.29 — Other disturbances of oral epithelium, including tongue (mouth), K51.90 — Ulcerative colitis, unspecified, without complications (in, ulcerative colitis NEC), K90.81 — Whipple's disease (in, Whipple's disease), L51.9 — Erythema multiforme, unspecified (in, erythema, multiforme), L52 — Erythema nodosum (in, erythema, nodosum), M02.00 — Arthropathy following intestinal bypass, unspecified site (following intestinal bypass), M02.01 — Arthropathy following intestinal bypass, shoulder (following intestinal bypass, shoulder), M02.02 — Arthropathy following intestinal bypass, elbow (following intestinal bypass, elbow), M02.03 — Arthropathy following intestinal bypass, wrist (following intestinal bypass, wrist), M02.04 — Arthropathy following intestinal bypass, hand (following intestinal bypass, hand joint), M02.05 — Arthropathy following intestinal bypass, hip (following intestinal bypass, hip), M02.06 — Arthropathy following intestinal bypass, knee (following intestinal bypass, knee), M02.07 — Arthropathy following intestinal bypass, ankle and foot (following intestinal bypass, ankle), +110 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Lipid Panel

Contextual Map

Every relationship of L40.59 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run L40.59 with this related code in Claim Check

Hierarchy

Referenced by Excludes1 notes

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

  • HCC 93 — Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders [CMS-HCC]: “Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders — supersedes HCC 94 (Systemic Lupus Erythematosus and Other Specified Systemic Connective Tissue Disorders)”— CMS-HCC V28 · 2026

MS-DRG Grouper

MDC crossing

  • MDC 08 — Diseases and Disorders of the Musculoskeletal System and Connective Tissue[MDC crossing]: “Diseases and Disorders of the Musculoskeletal System and Connective Tissue — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 18,508 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

  • Arthropathy, psoriatic NEC[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Psoriasis, arthropathic, other specified[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (14)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page
Risk adjustment Official source data
2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "L40.59 — Other psoriatic arthropathy." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/l40.59-other-psoriatic-arthropathy

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Other psoriatic arthropathy

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to L40.59 in its code family, with their registry titles.

View all codes in the L40 family