Rheumatoid nodule, multiple sites

This code signifies the presence of multiple rheumatoid nodules, which are firm, non-tender subcutaneous lumps typically found over bony prominences or extensor surfaces in patients with rheumatoid arthritis. These nodules are a common extra-articular manifestation of the disease, indicating more severe or long-standing rheumatoid arthritis.

Use this code when documentation clearly indicates the presence of rheumatoid nodules affecting several distinct anatomical locations. This diagnosis is often made clinically, but imaging or biopsy may confirm the nodular nature. It should be assigned when the physician explicitly states "multiple sites" or lists several distinct locations of nodules.

• Ensure documentation specifies "multiple sites" for the nodules; otherwise, a more specific site code should be used.
• Always code the underlying rheumatoid arthritis (e.g., M05.- or M06.0-) as the primary diagnosis, with this code as a secondary diagnosis.
• Distinguish from other subcutaneous nodules that are not rheumatoid in origin, such as gouty tophi or xanthomas.