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ICD-10 Guide
ICD-10 CodesM66.10

M66.10

Billable

Rupture of synovium, unspecified joint

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/17/2025

Code Description

ICD-10 M66.10 is a billable code used to indicate a diagnosis of rupture of synovium, unspecified joint.

Key Diagnostic Point:

Rupture of the synovium refers to the tearing or disruption of the synovial membrane that lines the joints and tendon sheaths. This condition can occur due to trauma, overuse, or underlying inflammatory diseases such as rheumatoid arthritis. The synovium plays a crucial role in joint health by producing synovial fluid, which lubricates the joint and nourishes the cartilage. When the synovium ruptures, it can lead to joint swelling, pain, and decreased mobility. Symptoms may include localized tenderness, swelling, and sometimes a palpable mass if a hematoma forms. Diagnosis typically involves a thorough clinical examination, imaging studies such as ultrasound or MRI, and sometimes arthroscopy. Treatment may vary from conservative management, including rest and physical therapy, to surgical intervention for severe cases. Surgical options may include synovectomy or repair of the ruptured synovium, depending on the extent of the damage and the joint involved. Accurate coding is essential for proper reimbursement and to reflect the complexity of the patient's condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of the rupture
  • Need for precise documentation of the joint involved
  • Differentiation from other synovial disorders like tenosynovitis
  • Potential for surgical intervention and associated codes

Audit Risk Factors

  • Inadequate documentation of the joint affected
  • Failure to specify the nature of the rupture
  • Misclassification of the condition as a different synovial disorder
  • Lack of supporting imaging or clinical notes

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed notes on the mechanism of injury, joint involved, and treatment plan.

Common Clinical Scenarios

Acute injuries from sports, chronic conditions in older adults, and post-surgical complications.

Billing Considerations

Ensure clarity on whether the rupture is acute or chronic and document any associated injuries.

Rheumatology

Documentation Requirements

Comprehensive history of inflammatory conditions, treatment history, and response to therapy.

Common Clinical Scenarios

Patients with rheumatoid arthritis experiencing joint swelling and pain.

Billing Considerations

Document any underlying autoimmune conditions that may contribute to synovial rupture.

Coding Guidelines

Inclusion Criteria

Use M66.10 When
  • Follow official ICD
  • CM coding guidelines, ensuring that the code reflects the specific joint involved when possible
  • Use additional codes to specify any associated conditions or complications

Exclusion Criteria

Do NOT use M66.10 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

29875CPT Code

Arthroscopy, knee, diagnostic, with or without synovial biopsy

Clinical Scenario

Used when a patient presents with knee pain and swelling, and a synovial rupture is suspected.

Documentation Requirements

Document the findings during the arthroscopy and any interventions performed.

Specialty Considerations

Orthopedic surgeons should ensure that the procedure is linked to the diagnosis of synovial rupture.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of synovial disorders, improving the accuracy of diagnoses and treatment plans. M66.10 provides a general code for unspecified joints, but coders are encouraged to specify the joint when possible for better data accuracy.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of synovial disorders, improving the accuracy of diagnoses and treatment plans. M66.10 provides a general code for unspecified joints, but coders are encouraged to specify the joint when possible for better data accuracy.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of synovial disorders, improving the accuracy of diagnoses and treatment plans. M66.10 provides a general code for unspecified joints, but coders are encouraged to specify the joint when possible for better data accuracy.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the difference between M66.10 and M66.11?

M66.10 is used for a rupture of the synovium in an unspecified joint, while M66.11 specifies a rupture in the right knee. Accurate coding requires specifying the joint when possible.