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ICD-10 Guide
ICD-10 CodesM66.178

M66.178

Billable

Rupture of synovium, left toe(s)

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

Code Description

ICD-10 M66.178 is a billable code used to indicate a diagnosis of rupture of synovium, left toe(s).

Key Diagnostic Point:

Rupture of the synovium in the left toe(s) refers to the tearing or disruption of the synovial membrane that lines the joints and tendon sheaths in the toes. This condition can result from acute trauma, chronic overuse, 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 joint and nourishes the cartilage. When the synovium ruptures, it can lead to pain, swelling, and decreased mobility in the affected toe(s). Patients may present with localized tenderness, swelling, and sometimes a palpable defect in the area. Diagnosis typically involves a thorough clinical examination, imaging studies such as ultrasound or MRI, and possibly aspiration of joint fluid to assess for inflammatory markers. Treatment may include conservative measures like rest, ice, compression, and elevation (RICE), as well as corticosteroid injections or surgical intervention in severe cases. Surgical repair may involve synovectomy or tendon repair if associated tendons are also affected.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between acute and chronic conditions
  • Identifying associated tendon injuries
  • Understanding the implications of underlying inflammatory diseases
  • Documenting the specific location and extent of the rupture

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the exact location of the rupture
  • Lack of supporting imaging studies
  • Inconsistent coding of associated conditions

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Acute injuries from sports activities, chronic pain in patients with arthritis.

Billing Considerations

Ensure clear documentation of any surgical interventions performed.

Rheumatology

Documentation Requirements

Comprehensive assessment of systemic symptoms and history of inflammatory diseases.

Common Clinical Scenarios

Patients with rheumatoid arthritis presenting with joint swelling and pain.

Billing Considerations

Document any systemic involvement and treatment plans for underlying conditions.

Coding Guidelines

Inclusion Criteria

Use M66.178 When
  • Follow official ICD
  • CM guidelines for coding synovial disorders
  • Ensure accurate documentation of the rupture's location and any associated conditions

Exclusion Criteria

Do NOT use M66.178 When
  • Exclude codes for conditions that do not involve the synovium

Related ICD-10 Codes

Related CPT Codes

28200CPT Code

Excision of a lesion of the toe

Clinical Scenario

Used when surgical intervention is required for ruptured synovium.

Documentation Requirements

Document the indication for surgery and findings during the procedure.

Specialty Considerations

Orthopedic surgeons should ensure detailed operative notes.

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 ruptures, improving data accuracy and patient care tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like synovial ruptures, improving data accuracy and patient care tracking.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like synovial ruptures, improving data accuracy and patient care tracking.

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 in the toes?

Common causes include acute trauma from sports injuries, chronic overuse from repetitive activities, and underlying inflammatory conditions such as rheumatoid arthritis or gout.