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v1.0.0
ICD-10 Guide
ICD-10 CodesM66.112

M66.112

Billable

Rupture of synovium, left shoulder

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

Code Description

ICD-10 M66.112 is a billable code used to indicate a diagnosis of rupture of synovium, left shoulder.

Key Diagnostic Point:

Rupture of the synovium in the left shoulder is a condition characterized by the tearing of the synovial membrane, which lines the joint and produces synovial fluid. This condition can result from acute trauma, repetitive strain, or underlying inflammatory conditions such as rheumatoid arthritis. Patients may present with symptoms including localized pain, swelling, and reduced range of motion in the shoulder. The rupture can lead to joint effusion and may be associated with tenosynovitis, where the tendon sheath becomes inflamed. Diagnosis typically involves a thorough clinical examination, imaging studies such as MRI or ultrasound, and sometimes arthroscopy for direct visualization. Treatment options may include conservative management with rest, ice, and anti-inflammatory medications, or surgical intervention to repair the synovium and address any associated tendon injuries. Accurate coding is essential for proper reimbursement and to reflect the complexity of the condition and its management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between acute and chronic conditions
  • Identifying associated injuries (e.g., tendon ruptures)
  • Understanding the implications of surgical versus non-surgical treatment
  • Variability in documentation quality among providers

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify laterality (left vs. right)
  • Lack of imaging studies to support diagnosis
  • Inconsistent terminology used in clinical notes

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative notes, imaging results, and pre-operative assessments are essential.

Common Clinical Scenarios

Patients presenting with acute shoulder pain following trauma or chronic pain with a history of repetitive use.

Billing Considerations

Ensure that all surgical interventions are documented, including any repairs or debridement performed.

Rheumatology

Documentation Requirements

Comprehensive history of joint symptoms, laboratory results, and imaging studies.

Common Clinical Scenarios

Patients with inflammatory arthritis presenting with joint swelling and pain.

Billing Considerations

Documenting the relationship between underlying rheumatological conditions and synovial rupture is crucial.

Coding Guidelines

Inclusion Criteria

Use M66.112 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the condition's specifics, including laterality and associated injuries
  • Include any relevant history of trauma or underlying conditions

Exclusion Criteria

Do NOT use M66.112 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

29827CPT Code

Arthroscopy, shoulder, diagnostic, with or without synovial biopsy

Clinical Scenario

Used when performing an arthroscopy to assess the extent of synovial damage.

Documentation Requirements

Operative report detailing findings and procedures performed.

Specialty Considerations

Orthopedic surgeons should ensure clear documentation of the surgical approach and findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding conditions like synovial rupture, improving the accuracy of clinical data and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding conditions like synovial rupture, improving the accuracy of clinical data and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 primary cause of synovial rupture?

Synovial rupture can be caused by acute trauma, repetitive strain, or underlying inflammatory conditions such as rheumatoid arthritis.