ICD 10 Coding Alert

Reader Questions:

Peek at This Palindromic Rheumatism Case

Question: The notes from my podiatrist reveal that a patient has been diagnosed with “palindromic rheumatism,” a condition that I’m not familiar with. Could you explain what the term means, and how to choose the correct ICD-10-CM code for the condition?

Alabama Subscriber

Answer: Palindromic rheumatism is an uncommon type of inflammatory arthritis, marked by periodic bouts of joint discomfort, swelling, and inflammation. These flare-ups usually persist for several hours to a few days, after which they completely vanish, causing no permanent harm to the joints. It’s dubbed palindromic because the episodes come and go in a pattern similar to a palindrome — a word or phrase that reads the same forward and backward (radar, civic, etc.).

Some patients with palindromic rheumatism will eventually develop rheumatoid arthritis (RA), while others continue to experience episodic symptoms without progression to a more severe form of arthritis.

You’ll report palindromic rheumatism with a code from one of the following sets, depending on encounter specifics:

  • M12.30 (Palindromic rheumatism, unspecified site)
  • M12.37- (Palindromic rheumatism, ankle and foot)
  • M12.39 (Palindromic rheumatism, multiple sites).