Orthopedic Coding Alert

Question: Encounter notes indicate that a patient suffered from ‘palindromic rheumatism.’ I’ve never heard of this condition. Could you explain what the term means, and how to choose an ICD-10 code for the condition?

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Answer: Palindromic rheumatism is a rare form of inflammatory arthritis characterized by recurrent episodes of joint pain, swelling, and inflammation. These episodes typically last for a few hours to a few days, and then the symptoms disappear completely, leaving no lasting damage 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 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)
• M12.31- (Palindromic rheumatism, shoulder)
• M12.32- (Palindromic rheumatism, elbow)
• M12.33- (Palindromic rheumatism, wrist)
• M12.34- (Palindromic rheumatism, hand)
• M12.35- (Palindromic rheumatism, hip)
• M12.36- (Palindromic rheumatism, knee)
• M12.37- (Palindromic rheumatism, ankle and foot)
• M12.38- (Palindromic rheumatism, other specified site)
• M12.39 (Palindromic rheumatism, multiple sites).