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ICD-10 Guide
ICD-10 CodesM66.173

M66.173

Billable

Rupture of synovium, unspecified ankle

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

Code Description

ICD-10 M66.173 is a billable code used to indicate a diagnosis of rupture of synovium, unspecified ankle.

Key Diagnostic Point:

Rupture of the synovium in the ankle is a condition characterized by the tearing of the synovial membrane, which lines the joint and produces synovial fluid. This membrane plays a crucial role in joint lubrication and nourishment. A rupture can occur due to trauma, overuse, or underlying inflammatory conditions such as rheumatoid arthritis or gout. Symptoms typically include localized swelling, pain, and reduced range of motion in the affected ankle. Diagnosis is often made through physical examination and imaging studies such as MRI or ultrasound, which can visualize the extent of the rupture and any associated joint effusion. Treatment may involve conservative measures such as rest, ice, compression, and elevation (RICE), as well as physical therapy. In more severe cases, surgical intervention may be necessary to repair the synovium or address any underlying issues. Accurate coding is essential for proper reimbursement and to reflect the severity of the condition in clinical documentation.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of symptoms
  • Need for precise documentation of the rupture's location and extent
  • Differentiation from other synovial disorders such as tenosynovitis
  • Potential for concurrent injuries or conditions affecting the ankle

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the side of the ankle affected
  • Lack of imaging studies to support the diagnosis
  • Inconsistent terminology used in clinical notes

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Acute ankle injuries from sports, chronic pain due to overuse, and post-surgical evaluations.

Billing Considerations

Orthopedic documentation must clearly outline the extent of the rupture and any surgical interventions performed.

Rheumatology

Documentation Requirements

Comprehensive assessment of underlying inflammatory conditions and their impact on synovial health.

Common Clinical Scenarios

Patients with rheumatoid arthritis presenting with joint swelling and pain.

Billing Considerations

Rheumatology notes should include details on systemic symptoms and laboratory findings to support the diagnosis.

Coding Guidelines

Inclusion Criteria

Use M66.173 When
  • According to ICD
  • 10 guidelines, M66
  • 173 should be used when the rupture of the synovium is confirmed but not specified as right or left
  • Coders must ensure that the documentation supports the diagnosis and that no other specific codes apply

Exclusion Criteria

Do NOT use M66.173 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

29875CPT Code

Arthroscopy, ankle, surgical

Clinical Scenario

Used when surgical intervention is required for repair of the ruptured synovium.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic surgeons must document the extent of the injury and the surgical approach taken.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of synovial injuries, improving the accuracy of claims and facilitating better patient management. M66.173 provides a clear designation for unspecified ruptures, which aids in tracking and treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of synovial injuries, improving the accuracy of claims and facilitating better patient management. M66.173 provides a clear designation for unspecified ruptures, which aids in tracking and treatment outcomes.

Reimbursement & Billing Impact

reimbursement and reflects the complexity of the patient's condition.

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 M66.173 and M66.171?

M66.173 is used for unspecified ruptures of the synovium in the ankle, while M66.171 specifies a rupture in the left ankle. Accurate coding requires documentation to determine the correct side.