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ICD-10 Guide
ICD-10 CodesM66.23

M66.23

Billable

Spontaneous rupture of extensor tendons, forearm

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

Code Description

ICD-10 M66.23 is a billable code used to indicate a diagnosis of spontaneous rupture of extensor tendons, forearm.

Key Diagnostic Point:

Spontaneous rupture of extensor tendons in the forearm is a condition characterized by the unexpected tearing of the extensor tendons, which are responsible for extending the fingers and wrist. This condition can occur without any significant trauma or injury, often seen in individuals with underlying conditions such as rheumatoid arthritis or chronic tenosynovitis. The rupture may lead to functional impairment, pain, and swelling in the affected area. Diagnosis typically involves a thorough clinical examination and imaging studies, such as ultrasound or MRI, to confirm the extent of the rupture and assess any associated injuries. Treatment options may include conservative management with splinting and physical therapy, or surgical intervention to repair the ruptured tendon, depending on the severity of the injury and the patient's overall health. Proper coding is essential for accurate billing and to ensure that the patient's medical history reflects the complexity of their condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between spontaneous and traumatic ruptures
  • Identifying associated conditions like tenosynovitis
  • Understanding the implications of surgical versus conservative treatment
  • Documenting the extent of the rupture accurately

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the exact tendon involved
  • Lack of imaging studies to support the diagnosis
  • Improper coding of associated conditions

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed operative reports and imaging results are essential for accurate coding.

Common Clinical Scenarios

Patients presenting with wrist pain and loss of function after a sudden onset of symptoms.

Billing Considerations

Ensure that the surgical notes clearly indicate the type of repair performed and any complications.

Rheumatology

Documentation Requirements

Comprehensive history of joint and tendon issues, including any autoimmune conditions.

Common Clinical Scenarios

Patients with a history of rheumatoid arthritis presenting with tendon ruptures.

Billing Considerations

Document any underlying inflammatory conditions that may contribute to tendon weakness.

Coding Guidelines

Inclusion Criteria

Use M66.23 When
  • According to ICD
  • 10 guidelines, M66
  • 23 should be used when there is clear documentation of a spontaneous rupture of extensor tendons in the forearm
  • It is important to ensure that the documentation supports the diagnosis and that any associated conditions are also coded appropriately

Exclusion Criteria

Do NOT use M66.23 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

26301CPT Code

Repair of extensor tendon

Clinical Scenario

Used when surgical repair is performed for a ruptured extensor tendon.

Documentation Requirements

Operative report detailing the procedure and any complications.

Specialty Considerations

Orthopedic surgeons should provide detailed notes on the surgical approach and post-operative care.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of tendon injuries, improving the accuracy of patient records and facilitating better treatment planning.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of tendon injuries, improving the accuracy of patient records and facilitating better treatment planning.

Reimbursement & Billing Impact

reimbursement and to reflect the complexity of care provided.

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 spontaneous rupture of extensor tendons?

Spontaneous ruptures are often associated with underlying conditions such as rheumatoid arthritis, chronic tenosynovitis, or degenerative changes in the tendon due to age or repetitive stress.