ICD-10 M05
Non-Billable HeaderRheumatoid arthritis with rheumatoid factor
About ICD-10-CM M05
ICD-10-CM code M05 represents Rheumatoid arthritis with rheumatoid factor. This is a non-billable header code in the Musculoskeletal and Connective Tissue chapter (block M05). The 2026 edition of ICD-10-CM M05 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Type 1 Excludes
Pure excludes, these codes can never be coded together with M05. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- rheumatic fever (I00)
- juvenile rheumatoid arthritis (M08.-)
- rheumatoid arthritis of spine (M45.-)
Medicare LCD Coverage for M05
Local Coverage Determinations (LCDs) from CMS MACs that list M05 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing M05.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but M05 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with M05
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To M05
Other codes in section M05-M14 (Inflammatory polyarthropathies).
ICD-10 M05, Billing FAQ
Is ICD-10 code M05 billable? +
No, M05 is a non-billable header code. Use a more specific child code from block M05 when submitting claims.
What codes are Type 1 Excludes for M05? +
Type 1 Excludes (never code together with M05): rheumatic fever (I00); juvenile rheumatoid arthritis (M08.-); rheumatoid arthritis of spine (M45.-)
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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