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ICD-10 Guide
ICD-10 CodesM66.17

M66.17

Billable

Rupture of synovium, ankle, foot and toes

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

Code Description

ICD-10 M66.17 is a billable code used to indicate a diagnosis of rupture of synovium, ankle, foot and toes.

Key Diagnostic Point:

Rupture of the synovium in the ankle, foot, and toes is a condition characterized by the tearing of the synovial membrane, which lines the joints and tendon sheaths. This injury can occur due to trauma, repetitive stress, or underlying inflammatory conditions such as rheumatoid arthritis or gout. The synovium plays a crucial role in joint health by producing synovial fluid, which lubricates the joints and nourishes the cartilage. When the synovium ruptures, it can lead to swelling, pain, and decreased range of motion in the affected area. Patients may present with symptoms such as localized tenderness, swelling, and sometimes a palpable defect in the tendon sheath. Diagnosis typically involves a thorough clinical examination, imaging studies like ultrasound or MRI, and sometimes aspiration of joint fluid. Treatment may include conservative measures such as rest, ice, compression, and elevation (RICE), as well as physical therapy. In severe cases, surgical intervention may be necessary to repair the ruptured synovium or to address any associated tendon injuries.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between acute and chronic ruptures
  • Identifying associated tendon injuries
  • Variability in clinical presentation
  • Need for precise documentation of symptoms and imaging findings

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the exact location of the rupture
  • Lack of imaging results in the medical record
  • Misclassification of the injury as a sprain or strain

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed notes on the mechanism of injury, physical examination findings, and imaging results.

Common Clinical Scenarios

Patients presenting with acute ankle injuries, chronic pain in the foot, or post-surgical follow-ups.

Billing Considerations

Ensure that all relevant imaging studies are included in the documentation to support the diagnosis.

Rheumatology

Documentation Requirements

Comprehensive assessment of joint involvement, history of inflammatory conditions, and treatment plans.

Common Clinical Scenarios

Patients with rheumatoid arthritis experiencing joint swelling and pain.

Billing Considerations

Document any systemic symptoms or laboratory findings that may indicate an underlying rheumatologic condition.

Coding Guidelines

Inclusion Criteria

Use M66.17 When
  • According to ICD
  • 10 guidelines, M66
  • 17 should be used when there is a confirmed rupture of the synovium in the specified anatomical locations
  • It is important to document the cause of the rupture and any associated injuries

Exclusion Criteria

Do NOT use M66.17 When
  • Exclusions include ruptures due to surgical procedures or those that are part of a systemic disease process

Related ICD-10 Codes

Related CPT Codes

29875CPT Code

Arthroscopy, ankle, surgical intervention

Clinical Scenario

Used when surgical repair of the ruptured synovium is performed.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic surgeons should ensure accurate documentation of the surgical approach and any complications.

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 M66.17, improving the accuracy of data collection and reimbursement processes. It provides a clearer picture of patient conditions, which can enhance treatment planning and outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like M66.17, improving the accuracy of data collection and reimbursement processes. It provides a clearer picture of patient conditions, which can enhance treatment planning and outcomes.

Reimbursement & Billing Impact

reimbursement processes. It provides a clearer picture of patient conditions, which can enhance treatment planning and outcomes.

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 synovium rupture?

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

How is a rupture of the synovium diagnosed?

Diagnosis typically involves a clinical examination, imaging studies such as ultrasound or MRI, and sometimes aspiration of joint fluid to assess for inflammation or infection.