ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 M05.571

Billable / Specific HCC v28: 75

Rheumatoid polyneuropathy with rheumatoid arthritis of right ankle and foot

M05
Block
0
Synonyms
620
LCDs
33
Payer Policies
0
Linked CPTs

About ICD-10-CM M05.571

ICD-10-CM code M05.571 represents Rheumatoid polyneuropathy with rheumatoid arthritis of right ankle and foot. This is a billable/specific code in the Musculoskeletal and Connective Tissue chapter (block M05). The 2026 edition of ICD-10-CM M05.571 became effective on October 1, 2025.

Coding Tips for M05.571

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

HCC capture: document with MEAT each year

M05.571 is a CMS-HCC v28 risk-adjustment code (category 75). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 75
ESRD-HCC
Category 75
RxHCC (Part D)
Category 75

Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.

Medicare LCD Coverage for M05.571

Local Coverage Determinations (LCDs) from CMS MACs that list M05.571 as a covered diagnosis.

620 LCDs

Showing top 10 of 620 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92201 →
CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92250 →
CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92202 →
CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92227 →
CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92228 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57307, Effective: 2025-11-06 00:00:00, 1126 covered, 0 non-covered
CPT 95909 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57307, Effective: 2025-11-06 00:00:00, 1126 covered, 0 non-covered
CPT 95887 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57307, Effective: 2025-11-06 00:00:00, 1126 covered, 0 non-covered
CPT 95912 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57307, Effective: 2025-11-06 00:00:00, 1126 covered, 0 non-covered
CPT 95999 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57307, Effective: 2025-11-06 00:00:00, 1126 covered, 0 non-covered
CPT 95910 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing M05.571.

33 policies

3 Cigna

Electrodiagnostic Testing (EMG/NCV) - (CPG129)
Policy ID: CPG129_EMG_NCV_SSEP
Orthotic Devices and Shoes - (0543)
Policy ID: MM_0543
Peripheral Nerve Destruction for Pain Conditions - (0525) ---- future effective policy
Policy ID: MM_0525

5 Medicare

Billing and Coding: Infliximab and biosimilars
Policy ID: ART-52423
Billing and Coding: Routine Foot Care
Policy ID: ART-52996
Billing and Coding: Home Health Occupational Therapy
Policy ID: ART-53057
Billing and Coding: Home Health Physical Therapy
Policy ID: ART-53058
Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Policy ID: ART-53060

CPT Codes Commonly Billed with M05.571

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for M05.571

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.

Convert M05.571 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
M05.571 3571 10112
M05.571 7140 10111

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 M05.571, Billing FAQ

Is ICD-10 code M05.571 billable? +

Yes, M05.571 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Does M05.571 affect Medicare Advantage HCC risk adjustment? +

Yes. M05.571 maps to CMS-HCC v28 category 75. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What ICD-9 codes does M05.571 map to? +

Per CMS GEMs, M05.571 maps to ICD-9 codes: 3571, 7140. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on June 1, 2026.

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