ICD-10-CM Diagnosis Code M12.369 - Palindromic rheumatism, unspecified knee (original) (raw)
ICD List 2025-2026 Edition
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- 2026 ICD-10-CM Code M12.369
Palindromic rheumatism, unspecified knee
ICD-10-CM Code:
M12.369
ICD-10 Code for:
Palindromic rheumatism, unspecified knee
Is Billable?
Yes - Valid for Submission
Chronic Condition Indicator: [1]
Chronic
Code Navigator:
M12.369 is a billable diagnosis code used to specify a medical diagnosis of palindromic rheumatism, unspecified knee. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2025 through September 30, 2026.
Unspecified diagnosis codes like M12.369 are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.
- Code Information
- Approximate Synonyms
- Clinical Classification
- Tabular List of Diseases and Injuries
- Diagnostic Related Groups Mapping
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- Other Codes Used Similar Conditions
- Code History
- Diseases of the musculoskeletal system and connective tissue
M00–M99
The following list of clinical terms are approximate synonyms, alternative descriptions, or common phrases that might be used by patients, healthcare providers, or medical coders to describe the same condition. These synonyms and related diagnosis terms are often used when searching for an ICD-10 code, especially when the exact medical terminology is unclear. Whether you're looking for lay terms, similar diagnosis names, or common language alternatives, this list can help guide you to the correct ICD-10 classification.
- Palindromic rheumatism of knee
Clinical Classifications group individual ICD-10-CM diagnosis codes into broader, clinically meaningful categories. These categories help simplify complex data by organizing related conditions under common clinical themes.
They are especially useful for data analysis, reporting, and clinical decision-making. Even when diagnosis codes differ, similar conditions can be grouped together based on their clinical relevance. Each category is assigned a unique CCSR code that represents a specific clinical concept, often tied to a body system or medical specialty.
CCSR Code: MUS007
Inpatient Default: Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.
Outpatient Default: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.
Below are the ICD-9 codes that most closely match this ICD-10 code, based on the General Equivalence Mappings (GEMs). This ICD-10 to ICD-9 crosswalk tool is helpful for coders who need to reference legacy diagnosis codes for audits, historical claims, or approximate code comparisons.
ICD-9-CM: 719.36
Approximate Flag - The approximate mapping means this ICD-10 code does not have an exact ICD-9 equivalent. The matched code is the closest available option, but it may not fully capture the original diagnosis or clinical intent.
Rheumatoid Arthritis
What is rheumatoid arthritis?
Rheumatoid arthritis (RA) is a form of arthritis that causes pain, swelling, and stiffness in your joints. RA is an autoimmune disease. Although it is most common in the wrist and fingers, this disease can cause your immune system to attack any joint tissue. The inflammation (swelling) that comes with RA can also affect other body parts. Inflammation could cause medical issues in your eyes, skin, heart, nerves, blood, or lungs.
RA differs from osteoarthritis, a common arthritis that often comes with age. RA affects the lining of your joints and damages the tissue that covers the ends of the bones in a joint. Eventually, this might cause your joints to not work as well.
There is no cure for RA, but early treatment can help you manage symptoms, reduce joint damage, and lead a productive life.
Who is more likely to get rheumatoid arthritis?
Rheumatoid arthritis can happen at any age, but your risk increases as you become an older adult. Your chance of developing RA can also increase if:
- You're a woman. Women are more likely to get RA than men.
- You have a family history. If a member of your family has RA, you're more likely to get the disease.
- You're a smoker. Smoking over a long period of time increases your risk of getting RA and how serious the disease can be.
- You have other medical conditions that may increase your risk of getting RA. These include obesity, gum disease, and lung disease.
What causes rheumatoid arthritis?
No one knows what causes rheumatoid arthritis. A few things that might play a part in getting RA include:
- Your genes are parts of DNA in your cells that are passed down from your parents. Certain genes may increase your risk of getting rheumatoid arthritis, but not everyone with these genes gets RA.
- The environment, which includes things such as cigarette smoke, sometimes triggers RA symptoms.
- Hormones are chemical messengers in your bloodstream that control the actions of certain cells or organs. Researchers think that sex hormones might play a role in getting RA. Women are more likely to develop the disease, and RA symptoms may change during and after pregnancy.
What are the symptoms of rheumatoid arthritis?
Your immune system may start turning against your body's joints and tissues years before you notice any symptoms of RA. The changes from this type of immune malfunction usually settle in your joints.
RA affects people differently. You might have the disease for only a short time, or your symptoms might come and go. The severe form can be chronic (long-lasting) and may last a lifetime.
Symptoms of rheumatoid arthritis may include:
- Joint pain or stiffness when moving. This is usually worse in the morning or after inactivity. RA usually affects both joints. If one of your hands or knees is affected, so is the other.
- Joint tenderness, redness, and warmth.
- Joint swelling may make daily activities hard. These could include things such as combing your hair, buttoning your clothes, or bending your knees.
- Fatigue, fever, and a loss of appetite.
- Hard bumps (rheumatoid nodules) under your skin near the joints.
How is rheumatoid arthritis diagnosed?
There's no single test for rheumatoid arthritis. The disease develops over time. At first, you may only have a few symptoms, making it hard to diagnose RA in its early stages. To find out if you have RA, your health care provider may:
- Ask about your medical history, including your symptoms.
- Ask about your family health history, including relatives who have had RA.
- Do a physical exam, which includes checking your joints, looking for rashes or nodules, and listening to your chest for signs of inflammation in your lungs.
- Order blood tests or imaging studies (x-ray or ultrasound) to make sure other health conditions aren't causing your symptoms since they may be like other types of arthritis and joint conditions.
Your provider may refer you to a rheumatologist (a doctor who specializes in arthritis care) for tests, diagnosis, and care.
What are the treatments for rheumatoid arthritis?
There is no cure for RA, but early treatment can help prevent your symptoms from getting worse and damaging your joints. Treatment can include medicine, lifestyle changes, and surgery. These may slow or stop joint damage and reduce pain and swelling.
Your provider may use a combination of treatments. Your treatment may change based on your symptoms.
You can help manage your RA symptoms if you:
- Are physically active
- Keep a healthy weight
- Avoid injuries to your joints
- Avoid activities that have repetitive motions, like bending your knee over and over
- Stop smoking, or don't start
NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases
FY 2026 - No Change, effective from 10/1/2025 through 9/30/2026
FY 2025 - No Change, effective from 10/1/2024 through 9/30/2025
FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.