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v1.0.0
ICD-10 Guide
ICD-10 CodesM66.152

M66.152

Billable

Rupture of synovium, left hip

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

Code Description

ICD-10 M66.152 is a billable code used to indicate a diagnosis of rupture of synovium, left hip.

Key Diagnostic Point:

Rupture of the synovium in the left hip joint is a condition characterized by the tearing of the synovial membrane, which lines the joint capsule and produces synovial fluid. This condition can arise from acute trauma, chronic overuse, or underlying inflammatory diseases such as rheumatoid arthritis. The synovium plays a crucial role in joint lubrication and nourishment, and its rupture can lead to joint swelling, pain, and decreased range of motion. Patients may present with symptoms such as localized tenderness, effusion, and difficulty bearing weight on the affected leg. Diagnosis typically involves a thorough clinical examination, imaging studies like MRI or ultrasound, and sometimes arthroscopy for direct visualization. Treatment may include conservative measures such as rest, ice, and anti-inflammatory medications, or surgical intervention to repair the synovium if conservative management fails. Understanding the underlying causes and associated conditions is essential for effective management and coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between acute and chronic conditions
  • Identifying associated injuries or conditions
  • Understanding the implications of surgical versus non-surgical treatment
  • Navigating documentation requirements for different specialties

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify laterality (left vs. right)
  • Lack of imaging or surgical reports to support the diagnosis
  • Misclassification of the condition as a simple sprain or strain

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed operative reports, imaging studies, and follow-up notes are essential.

Common Clinical Scenarios

Patients presenting with hip pain after trauma, athletes with overuse injuries, and those with inflammatory joint diseases.

Billing Considerations

Ensure that the documentation clearly states the nature of the rupture and any surgical interventions performed.

Rheumatology

Documentation Requirements

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

Common Clinical Scenarios

Patients with rheumatoid arthritis experiencing joint effusion or acute exacerbations.

Billing Considerations

Document the relationship between underlying rheumatologic conditions and the synovial rupture.

Coding Guidelines

Inclusion Criteria

Use M66.152 When
  • Follow official ICD
  • CM guidelines for coding injuries, ensuring accurate documentation of the nature of the rupture and any associated conditions
  • Include laterality and specificity in coding

Exclusion Criteria

Do NOT use M66.152 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27301CPT Code

Arthroscopy, hip, diagnostic

Clinical Scenario

Used when performing a diagnostic arthroscopy for suspected synovial rupture.

Documentation Requirements

Operative report detailing findings and procedures performed.

Specialty Considerations

Orthopedic surgeons should ensure clear documentation of the diagnosis and procedure.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like synovial rupture, improving data accuracy and facilitating better patient management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like synovial rupture, improving data accuracy and facilitating better patient management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like synovial rupture, improving data accuracy and facilitating better patient management.

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 are the common causes of synovial rupture?

Common causes include acute trauma, repetitive stress injuries, and inflammatory conditions such as rheumatoid arthritis.