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M06.8A ICD-10-CM Code: Other specified rheumatoid arthritis, other specified site

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

Inpatient Payment Groups (MS-DRG)

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, 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 83

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

Official Registry Overview & Definition

Other specified rheumatoid arthritis, other specified site is a billable ICD-10-CM diagnosis code (M06.8A).

Change history

  • FY2021 — 2020-10-01
    Added to the code set
    Other specified rheumatoid arthritis, other specified site
    FY2021 changes

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.

Contextual Map

Every relationship of M06.8A 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.

Hierarchy

  • M00-M99 — Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue (M00-M99) (M00-M99) [Hierarchy]
  • M00-M25 — Arthropathies [Hierarchy]
  • M05-M14 — Inflammatory polyarthropathies [Hierarchy]

Clinical classification (CCSR)

  • MUS003 — Rheumatoid arthritis and related disease [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)”

Potential MS-DRG

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

MDC crossing · procedures (18508)

  • 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.”
  • 005T0ZZ — Destruction of Spinal Meninges, Open Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005T3ZZ — Destruction of Spinal Meninges, Percutaneous Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Percutaneous Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005T4ZZ — Destruction of Spinal Meninges, Percutaneous Endoscopic Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Percutaneous Endoscopic Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005W0Z3 — Destruction of Cervical Spinal Cord using Laser Interstitial Thermal Therapy, Open Approach [Same-MDC procedure]: “Destruction of Cervical Spinal Cord using Laser Interstitial Thermal Therapy, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005W0ZZ — Destruction of Cervical Spinal Cord, Open Approach [Same-MDC procedure]: “Destruction of Cervical Spinal Cord, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • and 18503 more

Index entries

  • Arthritis, arthritic (acute) (chronic) (nonpyogenic) (subacute), rheumatoid, specified type NEC, specified site NEC[Index term]

Nearest codes (40)

  • M06 — Other rheumatoid arthritis [Sibling]
  • M06.37 — Rheumatoid nodule, ankle and foot [Sibling]
  • M06.371 — Rheumatoid nodule, right ankle and foot [Sibling]
  • M06.372 — Rheumatoid nodule, left ankle and foot [Sibling]
  • M06.379 — Rheumatoid nodule, unspecified ankle and foot [Sibling]
  • M06.38 — Rheumatoid nodule, vertebrae [Sibling]
  • M06.39 — Rheumatoid nodule, multiple sites [Sibling]
  • M06.4 — Inflammatory polyarthropathy [Sibling]
  • and 32 more

Change history

  • FY2021 — Added to the code set [Change history]

Relationships & Classification

Clinical classification (AHRQ CCSR):MUS003 — Rheumatoid arthritis and related disease (default).

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

Potential MS-DRG Relationships (FY2026)

Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.

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.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to M06.8A in its code family, with their registry titles.

  • M06.86 — Other specified rheumatoid arthritis, knee
  • M06.861 — Other specified rheumatoid arthritis, right knee
  • M06.862 — Other specified rheumatoid arthritis, left knee
  • M06.869 — Other specified rheumatoid arthritis, unspecified knee
  • M06.87 — Other specified rheumatoid arthritis, ankle and foot
  • M06.871 — Other specified rheumatoid arthritis, right ankle and foot
  • M06.872 — Other specified rheumatoid arthritis, left ankle and foot
  • M06.879 — Other specified rheumatoid arthritis, unspecified ankle and foot
  • M06.88 — Other specified rheumatoid arthritis, vertebrae
  • M06.89 — Other specified rheumatoid arthritis, multiple sites

View all codes in the M06 family

Indexed Clinical Terms (1)

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code.

  • Arthritis, arthritic (acute) (chronic) (nonpyogenic) (subacute), rheumatoid, specified type NEC, specified site NEC