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ICD-10 Guide
ICD-10 CodesM66.249

M66.249

Billable

Spontaneous rupture of extensor tendons, unspecified hand

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

Code Description

ICD-10 M66.249 is a billable code used to indicate a diagnosis of spontaneous rupture of extensor tendons, unspecified hand.

Key Diagnostic Point:

Spontaneous rupture of extensor tendons in the hand 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 apparent trauma or injury, often linked to underlying synovial disorders or degenerative changes in the tendons. Patients may present with sudden loss of function in the affected fingers, pain, and swelling. The diagnosis is typically confirmed through clinical examination and imaging studies, such as ultrasound or MRI, which can reveal tendon discontinuity. Treatment options may include conservative management with splinting and physical therapy or surgical intervention to repair the ruptured tendon. Surgical repair aims to restore function and alleviate pain, and it may involve tendon grafting or direct suturing of the tendon ends. Post-operative rehabilitation is crucial for optimal recovery and regaining strength and mobility in the hand.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of tendon rupture
  • Need for precise documentation of the mechanism of injury
  • Differentiation from other tendon injuries or conditions
  • Potential for co-existing conditions affecting treatment and coding

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the affected hand
  • Lack of imaging studies to support diagnosis
  • Inconsistent documentation of treatment plans

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative reports, imaging studies, and post-operative notes are essential.

Common Clinical Scenarios

Patients presenting with acute hand pain and loss of function, often after minimal trauma.

Billing Considerations

Ensure clear documentation of the surgical approach and any grafting techniques used.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessments of functional limitations and rehabilitation progress notes.

Common Clinical Scenarios

Patients undergoing rehabilitation post-surgery for tendon repair.

Billing Considerations

Documenting the patient's response to therapy and any modifications to the rehabilitation plan.

Coding Guidelines

Inclusion Criteria

Use M66.249 When
  • According to ICD
  • 10 guidelines, M66
  • 249 should be used when the specific hand is not documented
  • Coders must ensure that the documentation supports the diagnosis of spontaneous rupture and that no other specific codes apply

Exclusion Criteria

Do NOT use M66.249 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

26340CPT 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 findings.

Specialty Considerations

Orthopedic surgeons should ensure accurate coding based on the surgical approach.

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 data collection and reimbursement. M66.249 provides a means to capture spontaneous ruptures that may not have been adequately represented in ICD-9.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of tendon injuries, improving the accuracy of data collection and reimbursement. M66.249 provides a means to capture spontaneous ruptures that may not have been adequately represented in ICD-9.

Reimbursement & Billing Impact

reimbursement. M66.249 provides a means to capture spontaneous ruptures that may not have been adequately represented in ICD-9.

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 spontaneous rupture of extensor tendons?

Common causes include chronic tenosynovitis, degenerative changes due to aging, and systemic conditions such as rheumatoid arthritis.

How is a spontaneous rupture of extensor tendons diagnosed?

Diagnosis is typically made through clinical evaluation, patient history, and imaging studies such as ultrasound or MRI to confirm tendon discontinuity.

What are the treatment options for this condition?

Treatment may involve conservative management with splinting and therapy or surgical repair, depending on the severity of the rupture.