2025 ICD-10-CM code M31.31
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Systemic connective tissue disorders - Systemic connective tissue disorders (M30-M36) Diseases of the musculoskeletal system and connective tissue (M00-M99) Feed
Wegener's granulomatosis with renal involvement.
No modifiers are applicable to ICD-10 codes. Modifiers are used with CPT and HCPCS codes.
Medical necessity for treatment of Wegener's granulomatosis with renal involvement is established by the presence of the disease and its potential for severe complications, including life-threatening organ damage (renal failure, respiratory distress).Treatment aims to control inflammation and prevent irreversible organ damage. Documentation must establish the presence of symptoms, diagnostic findings, and the need for intervention to prevent long-term organ damage.
The clinical responsibility for managing Wegener's granulomatosis (GPA) typically involves a multidisciplinary approach.A rheumatologist often plays a leading role in diagnosis and management of the systemic aspects of the disease.Other specialists, such as pulmonologists, nephrologists, otolaryngologists, and other specialists may be involved depending on organ system involvement. The clinical responsibilities include conducting a thorough history and physical examination, ordering and interpreting diagnostic tests (blood tests for ANCA, urinalysis, imaging studies, biopsies), initiating and monitoring treatment (immunosuppressive medications, corticosteroids), managing complications, and coordinating care with other specialists. Regular follow-up monitoring is crucial for disease activity and treatment response.
- Diseases of the musculoskeletal system and connective tissue (M00-M99)
- Systemic connective tissue disorders (M30-M36)
In simple words: This code describes a serious autoimmune disease called Wegener's granulomatosis (now often called granulomatosis with polyangiitis), which affects the blood vessels and can damage many parts of the body, especially the lungs and kidneys. Doctors diagnose it through physical exams, blood tests, and sometimes biopsies.
M31.31 in the ICD-10-CM classification system denotes Wegener's granulomatosis (currently known as granulomatosis with polyangiitis or GPA) with involvement of the kidneys.This systemic autoimmune disorder is characterized by inflammation of blood vessels, leading to damage in multiple organs, prominently including the nose, sinuses, ears, lungs, and kidneys.Diagnosis involves a comprehensive assessment of patient history, physical examination, blood tests (detecting antineutrophil cytoplasmic antibodies), urinalysis, and potentially a tissue biopsy.
Example 1: A 55-year-old male presents with persistent sinusitis, hemoptysis, and fatigue.Laboratory findings reveal elevated inflammatory markers and positive ANCA. Renal function tests show evidence of glomerulonephritis. A kidney biopsy confirms the diagnosis of Wegener's granulomatosis with renal involvement (M31.31)., A 40-year-old female with a history of upper respiratory tract infections presents with recurrent nosebleeds, shortness of breath, and decreased urine output. Diagnostic testing reveals granulomatous inflammation in the lungs and kidneys, along with elevated ANCA titers, leading to a diagnosis of Wegener's granulomatosis with renal involvement (M31.31)., A 60-year-old male experiences progressive hearing loss, nasal ulceration, and worsening kidney function.Biopsies confirm granulomatous inflammation in the affected areas, consistent with Wegener's granulomatosis. His renal involvement is significant enough to justify the application of M31.31.
Detailed patient history (including symptoms, duration, and relevant past medical history), physical examination findings, results of laboratory tests (complete blood count, inflammatory markers, ANCA, urinalysis, renal function tests), imaging studies (chest X-ray, CT scans, etc.), and pathology reports (biopsy results) are essential for accurate coding of Wegener's granulomatosis with renal involvement.Documentation should support the diagnosis, the severity of renal involvement and the level of care provided.
** This code should be used only when there is documented renal involvement in the context of Wegener's granulomatosis (GPA).The severity of renal involvement may influence treatment decisions and the overall prognosis.It is essential to thoroughly document all clinical findings and treatment interventions for accurate coding and reimbursement.
- Revenue Code: Revenue codes will vary depending on the specific services provided and the payer. Consult your local fee schedule for applicable codes.
- RVU: RVUs are not directly assigned to ICD-10 codes.Reimbursement depends on the specific procedures and services rendered, which would have associated CPT or HCPCS codes with corresponding RVU values. These would be used to calculate payment.
- Global Days: Not applicable to ICD-10 codes.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Fee Schedule: Not applicable to ICD-10 codes.Reimbursement rates for services rendered in relation to this diagnosis would be determined by using the appropriate CPT/HCPCS codes with associated fee schedules.
- Specialties:Rheumatology, Nephrology, Pulmonology, Otolaryngology
- Place of Service:The place of service can vary depending on the patient's condition and the services required. It could be an inpatient hospital, outpatient clinic, doctor's office, or other healthcare facility.