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

ICD-10 M05.579

Billable / Specific HCC v28: 75

Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified ankle and foot

M05
Block
0
Synonyms
88
LCDs
12
Payer Policies
0
Linked CPTs

About ICD-10-CM M05.579

ICD-10-CM code M05.579 represents Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified 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 M05.579 became effective on October 1, 2025.

Coding Tips for M05.579

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

HCC capture: document with MEAT each year

M05.579 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 M05.579

Local Coverage Determinations (LCDs) from CMS MACs that list M05.579 as a covered diagnosis.

88 LCDs

Showing top 10 of 88 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Sedimentation Rate, Erythrocyte
Article ID: 57657, Effective: 2024-10-01 00:00:00, 1430 covered, 1 non-covered
CPT 85651 →
CMS LCD: Billing and Coding: Sedimentation Rate, Erythrocyte
Article ID: 57657, Effective: 2024-10-01 00:00:00, 1430 covered, 1 non-covered
CPT 85652 →
CMS LCD: Billing and Coding: Infliximab
Article ID: 56432, Effective: 2026-01-01 00:00:00, 406 covered, 0 non-covered
CPT J1745 →
CMS LCD: Billing and Coding: Infliximab
Article ID: 56432, Effective: 2026-01-01 00:00:00, 406 covered, 0 non-covered
CPT Q5103 →
CMS LCD: Billing and Coding: Infliximab
Article ID: 56432, Effective: 2026-01-01 00:00:00, 406 covered, 0 non-covered
CPT Q5121 →
CMS LCD: Billing and Coding: Infliximab
Article ID: 56432, Effective: 2026-01-01 00:00:00, 406 covered, 0 non-covered
CPT Q5104 →
CMS LCD: Billing and Coding: Routine Foot Care
Article ID: 57188, Effective: 2025-10-01 00:00:00, 812 covered, 1 non-covered
CPT 11719 →
CMS LCD: Billing and Coding: Routine Foot Care
Article ID: 57188, Effective: 2025-10-01 00:00:00, 812 covered, 1 non-covered
CPT 11721 →
CMS LCD: Billing and Coding: Routine Foot Care
Article ID: 57188, Effective: 2025-10-01 00:00:00, 812 covered, 1 non-covered
CPT 11057 →
CMS LCD: Billing and Coding: Routine Foot Care
Article ID: 57188, Effective: 2025-10-01 00:00:00, 812 covered, 1 non-covered
CPT 11720 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing M05.579.

12 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: Infliximab
Policy ID: ART-56432
Billing and Coding: Biomarkers Overview
Policy ID: ART-56541
Billing and Coding: Routine Foot Care
Policy ID: ART-57188

CPT Codes Commonly Billed with M05.579

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

No procedure linkages on file for M05.579

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 M05.579 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
M05.579 3571 10112
M05.579 7140 10111

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

ICD-10 M05.579, Billing FAQ

Is ICD-10 code M05.579 billable? +

Yes, M05.579 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Does M05.579 affect Medicare Advantage HCC risk adjustment? +

Yes. M05.579 maps to CMS-HCC v28 category 75. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What ICD-9 codes does M05.579 map to? +

Per CMS GEMs, M05.579 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 May 31, 2026.

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