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ICD-10 Guide
ICD-10 CodesM66.242

M66.242

Billable

Spontaneous rupture of extensor tendons, left hand

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

Code Description

ICD-10 M66.242 is a billable code used to indicate a diagnosis of spontaneous rupture of extensor tendons, left hand.

Key Diagnostic Point:

Spontaneous rupture of extensor tendons in the left hand is a condition characterized by the sudden tearing of the tendons that extend the fingers and wrist, often occurring without any apparent trauma. This condition can result from chronic degeneration of the tendon tissue, inflammatory processes, or underlying systemic diseases such as rheumatoid arthritis. Patients may present with acute pain, swelling, and loss of function in the affected hand, particularly in extending the fingers. Diagnosis typically involves a thorough clinical examination and may be supported by imaging studies such as ultrasound or MRI to assess the extent of the rupture. Treatment options vary based on the severity of the rupture and may include conservative management with splinting and physical therapy or surgical intervention to repair the torn tendons. Surgical repair aims to restore function and alleviate pain, and rehabilitation is crucial for optimal recovery.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between spontaneous and traumatic ruptures
  • Understanding the specific anatomy of extensor tendons
  • Identifying associated conditions such as tenosynovitis
  • Documenting the precise location and extent of the rupture

Audit Risk Factors

  • Inadequate documentation of the spontaneous nature of the rupture
  • Failure to specify the exact tendon involved
  • Lack of imaging studies to support the diagnosis
  • Improper coding of associated conditions like tenosynovitis

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative notes, imaging results, and pre/post-operative assessments.

Common Clinical Scenarios

Surgical repair of ruptured extensor tendons, management of post-operative complications.

Billing Considerations

Ensure clear documentation of the surgical technique used and any grafts or implants utilized.

Physical Therapy

Documentation Requirements

Progress notes detailing patient assessments, treatment plans, and functional outcomes.

Common Clinical Scenarios

Rehabilitation following tendon repair, management of pain and swelling.

Billing Considerations

Document specific therapeutic exercises and patient responses to treatment.

Coding Guidelines

Inclusion Criteria

Use M66.242 When
  • Follow official ICD
  • CM coding guidelines, ensuring accurate documentation of the spontaneous nature of the rupture
  • Include any relevant history of tendon disorders or systemic diseases

Exclusion Criteria

Do NOT use M66.242 When
  • Exclude codes for traumatic ruptures unless specified

Related ICD-10 Codes

Related CPT Codes

26301CPT Code

Repair of extensor tendon

Clinical Scenario

Used when performing surgical repair of a ruptured extensor tendon.

Documentation Requirements

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

Specialty Considerations

Orthopedic surgeons should ensure that the surgical technique is clearly documented.

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 diagnoses and treatment plans. M66.242 provides a clear distinction for spontaneous ruptures, which aids in appropriate reimbursement and care management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of tendon injuries, improving the accuracy of diagnoses and treatment plans. M66.242 provides a clear distinction for spontaneous ruptures, which aids in appropriate reimbursement and care management.

Reimbursement & Billing Impact

reimbursement and care management.

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 injury or trauma, often due to degeneration or underlying conditions, while traumatic rupture is a direct result of an injury or accident.