M05.531: Rheumatoid polyneuropathy with rheumatoid arthritis of right wrist
M05.531, rheumatoid polyneuropathy with rheumatoid arthritis of right wrist, is listed as a covered diagnosis in 18 Medicare billing and coding articles that apply to 30 HCPCS Level II codes, including G0127 (Trimming of dystrophic nails, any number), J9312 (Injection, rituximab, 10 mg), Q5123 (Injection, rituximab-arrx, biosimilar, (riabni), 10 mg). The articles come from 7 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 M05.531 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| G0127 | Trimming of dystrophic nails, any number | Special coverage instructions apply | — | 4 |
| 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 | — | 3 |
| J0885 | Injection, epoetin alfa, (for non-esrd use), 1000 units | Special coverage instructions apply | — | 3 |
| Q5106 | Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units | Special coverage instructions apply | — | 3 |
| J0882 | Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis) | Special coverage instructions apply | — | 3 |
| Q5105 | Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units | Special coverage instructions apply | — | 3 |
| J0890 | Injection, peginesatide, 0.1 mg (for esrd on dialysis) | Carrier judgment | — | 3 |
| Q4081 | Injection, epoetin alfa, 100 units (for esrd on dialysis) | Special coverage instructions apply | — | 3 |
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg | Special coverage instructions apply | — | 2 |
| Q5104 | Injection, infliximab-abda, biosimilar, (renflexis), 10 mg | Special coverage instructions apply | — | 2 |
| Q5103 | Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg | Special coverage instructions apply | — | 2 |
| Q5121 | Injection, infliximab-axxq, biosimilar, (avsola), 10 mg | Carrier judgment | — | 2 |
| J0888 | Injection, epoetin beta, 1 microgram, (for non esrd use) | Special coverage instructions apply | — | 2 |
| J0887 | Injection, epoetin beta, 1 microgram, (for esrd on dialysis) | Special coverage instructions apply | — | 2 |
| 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 |
| 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 |
5 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing M05.531
- 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
- A56432: Billing and Coding: Infliximab (Palmetto GBA (MAC - Part A, MAC - Part B); 4 Level II codes). LCD with the same title: L35677
- 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)
- A57954: Billing and Coding: Routine Foot Care (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33941, L35138, L37643
- A57193: Billing and Coding: Routine Foot Care and Debridement of Nails (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33636, L34246
- A56380: Billing and Coding: Rituximab (Palmetto GBA (MAC - Part A, MAC - Part B); 6 Level II codes). LCD with the same title: L35026
- A52996: Billing and Coding: Routine Foot Care (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33941, L35138, L37643
- A57188: Billing and Coding: Routine Foot Care (First Coast Service Options, Inc. (MAC - Part B); 1 Level II codes). LCD with the same title: L33941, L35138, L37643
- 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
- A57307: Billing and Coding: Nerve Conduction Studies and Electromyography (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
- A57478: Billing and Coding: Nerve Conduction Studies and Electromyography (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
- A56462: Billing and Coding: Erythropoiesis Stimulating Agents (ESA) (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 7 Level II codes). LCD with the same title: L34356
- A60381: Billing and Coding: Erythropoiesis Stimulating Agents (Wellpoint Federal (MAC - Part A, MAC - Part B); 9 Level II codes). LCD with the same title: L39237
- A54969: Billing and Coding: Nerve Conduction Studies and Electromyography (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
3 more articles list M05.531.
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)
- M05.532 — Rheumatoid polyneuropathy with rheumatoid arthritis of left wrist
- M05.539 — Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified…
- M05.50 — Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified…
- M05.511 — Rheumatoid polyneuropathy with rheumatoid arthritis of right shoulder
- M05.512 — Rheumatoid polyneuropathy with rheumatoid arthritis of left shoulder
- M05.519 — Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified…
- M05.521 — Rheumatoid polyneuropathy with rheumatoid arthritis of right elbow
- M05.522 — Rheumatoid polyneuropathy with rheumatoid arthritis of left elbow
- M05.529 — Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified…
- M05.541 — Rheumatoid polyneuropathy with rheumatoid arthritis of right hand
- M05.542 — Rheumatoid polyneuropathy with rheumatoid arthritis of left hand
- M05.549 — Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified…
- M05.551 — Rheumatoid polyneuropathy with rheumatoid arthritis of right hip
- M05.552 — Rheumatoid polyneuropathy with rheumatoid arthritis of left hip
- M05.559 — Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified hip
- M05.561 — Rheumatoid polyneuropathy with rheumatoid arthritis of right knee
- M05.562 — Rheumatoid polyneuropathy with rheumatoid arthritis of left knee
- M05.569 — Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified…
- M05.571 — Rheumatoid polyneuropathy with rheumatoid arthritis of right ankle…
- M05.572 — Rheumatoid polyneuropathy with rheumatoid arthritis of left ankle…
- M05.579 — Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified…
- M05.59 — Rheumatoid polyneuropathy with rheumatoid arthritis of multiple sites
- 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
- M05.031 — Felty's syndrome, right wrist
- M05.032 — Felty's syndrome, left wrist
- M05.041 — Felty's syndrome, right hand
- M05.042 — Felty's syndrome, left hand
Frequently asked questions
Does Medicare cover M05.531 (Rheumatoid polyneuropathy with rheumatoid arthritis of…)?
Medicare covers items and services, not diagnoses. 18 Medicare billing and coding articles list M05.531 as a covered diagnosis for 30 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 M05.531?
The Level II codes from the policies most specific to this diagnosis are G0127 (Trimming of dystrophic nails, any number, 4 articles); 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). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list M05.531?
A56795 (Billing and Coding: Erythropoiesis Stimulating Agents (ESAs)); A56432 (Billing and Coding: Infliximab); A55639 (Billing and Coding: Chemotherapy Agents for Non-Oncologic Conditions), and 15 more articles.
What is ICD-10-CM code M05.531?
M05.531 is the ICD-10-CM code for rheumatoid polyneuropathy with rheumatoid arthritis of right 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 G0127
- Watch G0127 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0127
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