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M06.85 ICD-10-CM Code: Other specified rheumatoid arthritis, hip

Billing Status: NO. This is a non-billable ICD-10-CM code: report a more specific billable code beneath it.

Coder workflow for M06.85

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

Before you code M06.85

  1. M06.85 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

    ReviewM06.851, M06.852, M06.859

    See the relationships section · Guide: How to choose an ICD-10-CM code →

  2. “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 M06.85; 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).

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

Choose the right path

  1. Does the documentation support one of the more specific codes beneath M06.85?
    Yes → Select that code and continue the checks below on its own page.
    No → M06.85 cannot be reported as written; query for the specificity its subcategory needs.

    ReviewM06.851, M06.852, M06.859

Consider M06.85. Then confirm the code is valid for the date of service in the Verify section.

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).
Anatomical site
At the most specific level the record states; a site the classification separates cannot be assumed from a procedure or a measurement.
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.

Don’t confuse M06.85 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of M06.85 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • M06.80— Specificity relationship (Review)

    Overlapping diagnoses in the same category.

    Overlapping codes in the same category — the documentation decides which is the more specific fit.

    What moves you there: A record that documents no more than “Other specified rheumatoid arthritis, unspecified site” takes M06.80; specificity in the record moves it back here.

    Full comparison: M06.85 vs M06.80 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Code Overview

Other specified rheumatoid arthritis, hip is a non-billable ICD-10-CM category code (M06.85). A more specific billable subcode must be selected for claims submission.

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

Verify Before Coding

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 M06.85 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 2 Code First instructions: J84.170 — Interstitial lung disease with progressive fibrotic phenotype in diseases classified elsewhere (via M06.-), J84.178 — Other interstitial pulmonary diseases with fibrosis in diseases classified elsewhere (via M06.-).

Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.

Related Codes

Same Index main term, other category

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

M05.81 — Other rheumatoid arthritis with rheumatoid factor of shoulder (rheumatoid, seropositive, specified NEC, shoulder), M05.82 — Other rheumatoid arthritis with rheumatoid factor of elbow (rheumatoid, seropositive, specified NEC, elbow), M05.83 — Other rheumatoid arthritis with rheumatoid factor of wrist (rheumatoid, seropositive, specified NEC, wrist), M05.84 — Other rheumatoid arthritis with rheumatoid factor of hand (rheumatoid, seropositive, specified NEC, hand joint), M05.85 — Other rheumatoid arthritis with rheumatoid factor of hip (rheumatoid, seropositive, specified NEC, hip), M05.86 — Other rheumatoid arthritis with rheumatoid factor of knee (rheumatoid, seropositive, specified NEC, knee), M05.87 — Other rheumatoid arthritis with rheumatoid factor of ankle and foot (rheumatoid, seropositive, specified NEC, ankle), M05.89 — Other rheumatoid arthritis with rheumatoid factor of multiple sites (rheumatoid, seropositive, specified NEC, multiple sites), M05.8A — Other rheumatoid arthritis with rheumatoid factor of other specified site (rheumatoid, seropositive, specified NEC, specified site NEC), M05.9 — Rheumatoid arthritis with rheumatoid factor, unspecified (rheumatoid, seropositive), M08.00 — Unspecified juvenile rheumatoid arthritis of unspecified site (rheumatoid, juvenile), M08.01 — Unspecified juvenile rheumatoid arthritis, shoulder (rheumatoid, juvenile, shoulder), M08.02 — Unspecified juvenile rheumatoid arthritis of elbow (rheumatoid, juvenile, elbow), M08.03 — Unspecified juvenile rheumatoid arthritis, wrist (rheumatoid, juvenile, wrist), M08.04 — Unspecified juvenile rheumatoid arthritis, hand (rheumatoid, juvenile, hand joint), M08.05 — Unspecified juvenile rheumatoid arthritis, hip (rheumatoid, juvenile, hip), M08.06 — Unspecified juvenile rheumatoid arthritis, knee (rheumatoid, juvenile, knee), M08.07 — Unspecified juvenile rheumatoid arthritis, ankle and foot (rheumatoid, juvenile, ankle), M08.08 — Unspecified juvenile rheumatoid arthritis, vertebrae (rheumatoid, juvenile, vertebra), M08.09 — Unspecified juvenile rheumatoid arthritis, multiple sites (rheumatoid, juvenile, multiple site), +172 more

Contextual Map

Every relationship of M06.85 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 M06.85 with these 2 related codes in Claim Check

Hierarchy

Referenced by Code First instructions

Nearest codes (40)

Change history

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

Common coding questions

Can M06.85 be billed directly?

No. M06.85 (Other specified rheumatoid arthritis, hip) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

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 FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) 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. "M06.85 — Other specified rheumatoid arthritis, hip." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/m06.85-other-specified-rheumatoid-arthritis-hip

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Other specified rheumatoid arthritis, hip

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, 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 M06.85 in its code family, with their registry titles.

View all codes in the M06 family