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ICD-10 Guide
ICD-10 CodesM66.231

M66.231

Billable

Spontaneous rupture of extensor tendons, right forearm

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

Code Description

ICD-10 M66.231 is a billable code used to indicate a diagnosis of spontaneous rupture of extensor tendons, right forearm.

Key Diagnostic Point:

Spontaneous rupture of extensor tendons in the right 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 due to various factors, including underlying degenerative changes, inflammatory conditions, or acute trauma. Patients may present with sudden pain, swelling, and loss of function in the affected area. The diagnosis is typically confirmed through clinical examination and imaging studies, such as ultrasound or MRI, which can visualize the extent of the tendon rupture. Treatment often involves surgical intervention to repair the ruptured tendon, followed by rehabilitation to restore function. The prognosis varies depending on the severity of the rupture and the timeliness of treatment. Early intervention is crucial for optimal recovery and to prevent long-term complications such as stiffness or weakness in the hand and wrist.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between spontaneous and traumatic ruptures
  • Understanding the specific anatomical location of the rupture
  • Documenting associated conditions such as tenosynovitis
  • Navigating surgical repair coding and postoperative care

Audit Risk Factors

  • Inadequate documentation of the spontaneous nature of the rupture
  • Failure to specify the anatomical location accurately
  • Misclassification of the condition as a traumatic rupture
  • Lack of supporting imaging documentation

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative notes, imaging results, and preoperative assessments.

Common Clinical Scenarios

Patients presenting with acute pain and dysfunction in the wrist or fingers, often following a history of repetitive strain or underlying conditions.

Billing Considerations

Ensure that the surgical procedure performed is clearly documented, including any repairs or grafts used.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessments of functional limitations and rehabilitation progress notes.

Common Clinical Scenarios

Patients recovering from tendon repair surgery requiring rehabilitation to regain strength and range of motion.

Billing Considerations

Document the specific rehabilitation protocols and progress to support ongoing treatment.

Coding Guidelines

Inclusion Criteria

Use M66.231 When
  • According to ICD
  • 10 coding guidelines, M66
  • 231 should be used when the rupture is spontaneous and specifically located in the right forearm
  • Coders must ensure that the documentation supports the diagnosis and that any associated conditions are also coded appropriately

Exclusion Criteria

Do NOT use M66.231 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

26340CPT Code

Repair of tendon, extensor, forearm

Clinical Scenario

Used when performing surgical repair of the ruptured extensor tendon.

Documentation Requirements

Operative report detailing the procedure, including the type of repair and any grafts used.

Specialty Considerations

Orthopedic surgeons must document 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 spontaneous tendon ruptures, improving the accuracy of diagnoses and treatment tracking. This specificity aids in better patient management and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of spontaneous tendon ruptures, improving the accuracy of diagnoses and treatment tracking. This specificity aids in better patient management and resource allocation.

Reimbursement & Billing Impact

reimbursement and compliance.

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 spontaneous and traumatic tendon rupture?

Spontaneous tendon rupture occurs without a specific traumatic event, often due to underlying degenerative conditions, while traumatic rupture is a direct result of an identifiable injury or force.