M05.032: Felty's syndrome, left wrist
M05.032, Felty's syndrome, left wrist, is listed as a covered diagnosis in 7 Medicare billing and coding articles that apply to 28 HCPCS Level II codes, including J9312 (Injection, rituximab, 10 mg), Q5123 (Injection, rituximab-arrx, biosimilar, (riabni), 10 mg), Q5119 (Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg). The articles come from 3 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with M05.032 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| J9312 | Injection, rituximab, 10 mg | Special coverage instructions apply | — | 3 |
| Q5123 | Injection, rituximab-arrx, biosimilar, (riabni), 10 mg | Carrier judgment | — | 3 |
| Q5119 | Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg | Carrier judgment | — | 3 |
| Q5115 | Injection, rituximab-abbs, biosimilar, (truxima), 10 mg | Special coverage instructions apply | — | 3 |
| J0881 | Injection, darbepoetin alfa, 1 microgram (non-esrd use) | Special coverage instructions apply | — | 1 |
| J0885 | Injection, epoetin alfa, (for non-esrd use), 1000 units | Special coverage instructions apply | — | 1 |
| Q5106 | Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units | Special coverage instructions apply | — | 1 |
| J0882 | Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis) | Special coverage instructions apply | — | 1 |
| J0888 | Injection, epoetin beta, 1 microgram, (for non esrd use) | Special coverage instructions apply | — | 1 |
| Q5105 | Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units | Special coverage instructions apply | — | 1 |
| J0887 | Injection, epoetin beta, 1 microgram, (for esrd on dialysis) | Special coverage instructions apply | — | 1 |
| J0890 | Injection, peginesatide, 0.1 mg (for esrd on dialysis) | Carrier judgment | — | 1 |
| Q4081 | Injection, epoetin alfa, 100 units (for esrd on dialysis) | Special coverage instructions apply | — | 1 |
| J9260 | Injection, methotrexate sodium, 50 mg | Special coverage instructions apply | — | 1 |
| J9215 | Injection, interferon, alfa-n3, (human leukocyte derived), 250,000 iu | Special coverage instructions apply | — | 1 |
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg | Special coverage instructions apply | — | 1 |
| Q5104 | Injection, infliximab-abda, biosimilar, (renflexis), 10 mg | Special coverage instructions apply | — | 1 |
| Q5103 | Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg | Special coverage instructions apply | — | 1 |
| Q5121 | Injection, infliximab-axxq, biosimilar, (avsola), 10 mg | Carrier judgment | — | 1 |
| J9311 | Injection, rituximab 10 mg and hyaluronidase | Special coverage instructions apply | — | 1 |
| J3590 | Unclassified biologics | Carrier judgment | — | 1 |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | Carrier judgment | — | 2 |
| G0152 | Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0158 | Services performed by a qualified occupational therapist assistant in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0160 | Services performed by a qualified occupational therapist, in the home health setting, in the establishment or delivery of a safe and effective occupational therapy maintenance program, each 15 minutes | Carrier judgment | — | 1 |
3 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing M05.032
- A56795: Billing and Coding: Erythropoiesis Stimulating Agents (ESAs) (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 9 Level II codes). LCD with the same title: L34633
- A55639: Billing and Coding: Chemotherapy Agents for Non-Oncologic Conditions (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 6 Level II codes)
- A52423: Billing and Coding: Infliximab and biosimilars (Wellpoint Federal (MAC - Part A, MAC - Part B); 4 Level II codes)
- A56380: Billing and Coding: Rituximab (Palmetto GBA (MAC - Part A, MAC - Part B); 6 Level II codes). LCD with the same title: L35026
- A59101: Billing and Coding: Off-label Use of Rituximab and Rituximab Biosimilars (Wellpoint Federal (MAC - Part A, MAC - Part B); 4 Level II codes). LCD with the same title: L38920, L39297
- A53057: Billing and Coding: Home Health Occupational Therapy (Palmetto GBA (HHH MAC); 5 Level II codes). LCD with the same title: L34560
- A53064: Billing and Coding: Outpatient Occupational Therapy (Palmetto GBA (MAC - Part A); 3 Level II codes). LCD with the same title: L34427
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other M05 diagnoses (Rheumatoid arthritis with rheumatoid factor)
- M05.031 — Felty's syndrome, right wrist
- M05.011 — Felty's syndrome, right shoulder
- M05.012 — Felty's syndrome, left shoulder
- M05.021 — Felty's syndrome, right elbow
- M05.022 — Felty's syndrome, left elbow
- M05.041 — Felty's syndrome, right hand
- M05.042 — Felty's syndrome, left hand
- M05.051 — Felty's syndrome, right hip
- M05.052 — Felty's syndrome, left hip
- M05.061 — Felty's syndrome, right knee
- M05.062 — Felty's syndrome, left knee
- M05.071 — Felty's syndrome, right ankle and foot
- M05.072 — Felty's syndrome, left ankle and foot
- M05.09 — Felty's syndrome, multiple sites
- M05.10 — Rheumatoid lung disease with rheumatoid arthritis of unspecified site
- M05.111 — Rheumatoid lung disease with rheumatoid arthritis of right shoulder
- M05.112 — Rheumatoid lung disease with rheumatoid arthritis of left shoulder
- M05.121 — Rheumatoid lung disease with rheumatoid arthritis of right elbow
- M05.122 — Rheumatoid lung disease with rheumatoid arthritis of left elbow
- M05.131 — Rheumatoid lung disease with rheumatoid arthritis of right wrist
- M05.132 — Rheumatoid lung disease with rheumatoid arthritis of left wrist
- M05.141 — Rheumatoid lung disease with rheumatoid arthritis of right hand
- M05.142 — Rheumatoid lung disease with rheumatoid arthritis of left hand
- M05.151 — Rheumatoid lung disease with rheumatoid arthritis of right hip
- M05.152 — Rheumatoid lung disease with rheumatoid arthritis of left hip
- M05.161 — Rheumatoid lung disease with rheumatoid arthritis of right knee
- M05.162 — Rheumatoid lung disease with rheumatoid arthritis of left knee
- M05.171 — Rheumatoid lung disease with rheumatoid arthritis of right ankle and…
- M05.172 — Rheumatoid lung disease with rheumatoid arthritis of left ankle and…
- M05.19 — Rheumatoid lung disease with rheumatoid arthritis of multiple sites
Frequently asked questions
Does Medicare cover M05.032 (Felty's syndrome, left wrist)?
Medicare covers items and services, not diagnoses. 7 Medicare billing and coding articles list M05.032 as a covered diagnosis for 28 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 M05.032?
The Level II codes from the policies most specific to this diagnosis are J9312 (Injection, rituximab, 10 mg, 3 articles); Q5123 (Injection, rituximab-arrx, biosimilar, (riabni), 10 mg, 3 articles); Q5119 (Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg, 3 articles); Q5115 (Injection, rituximab-abbs, biosimilar, (truxima), 10 mg, 3 articles); J0881 (Injection, darbepoetin alfa, 1 microgram (non-esrd use), 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list M05.032?
A56795 (Billing and Coding: Erythropoiesis Stimulating Agents (ESAs)); A55639 (Billing and Coding: Chemotherapy Agents for Non-Oncologic Conditions); A52423 (Billing and Coding: Infliximab and biosimilars), and 4 more articles.
What is ICD-10-CM code M05.032?
M05.032 is the ICD-10-CM code for Felty's syndrome, left wrist, in category M05 (Rheumatoid arthritis with rheumatoid factor), chapter 13: Diseases of the musculoskeletal system and connective tissue.
Next steps
- Run a reimbursement report for a device billed under J9312
- Watch J9312 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9312
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 13: Diseases of the musculoskeletal system and connective tissue · All diagnoses · HCPCS lookup