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v1.0.0
ICD-10 Guide
ICD-10 CodesM66.271

M66.271

Billable

Spontaneous rupture of extensor tendons, right ankle and foot

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

Code Description

ICD-10 M66.271 is a billable code used to indicate a diagnosis of spontaneous rupture of extensor tendons, right ankle and foot.

Key Diagnostic Point:

Spontaneous rupture of extensor tendons in the right ankle and foot is a condition characterized by the unexpected tearing of the extensor tendons, which are responsible for extending the toes and lifting the foot. This condition can occur without any apparent trauma or injury, often associated with underlying conditions such as tenosynovitis, which is inflammation of the tendon sheath. 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 MRI or ultrasound, which can visualize tendon integrity. Treatment may involve conservative management, including rest, ice, and anti-inflammatory medications, or surgical intervention to repair the ruptured tendon, depending on the severity of the rupture and the patient's functional needs. Proper coding for this condition is crucial for accurate billing and reimbursement, as it reflects the complexity of the injury and the necessary treatment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between spontaneous and traumatic ruptures
  • Understanding associated conditions like tenosynovitis
  • Documentation of clinical findings and imaging results
  • Variability in treatment approaches (conservative vs. surgical)

Audit Risk Factors

  • Inadequate documentation of the spontaneous nature of the rupture
  • Failure to document associated conditions like tenosynovitis
  • Lack of imaging results to support the diagnosis
  • Incorrect coding of the anatomical site

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed clinical notes, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with acute pain and swelling in the ankle after a sudden movement.

Billing Considerations

Ensure that the documentation specifies the spontaneous nature of the rupture and any associated conditions.

Physical Medicine and Rehabilitation

Documentation Requirements

Functional assessments and rehabilitation plans.

Common Clinical Scenarios

Patients recovering from tendon repair surgery requiring rehabilitation.

Billing Considerations

Document the patient's functional limitations and progress throughout rehabilitation.

Coding Guidelines

Inclusion Criteria

Use M66.271 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the condition's spontaneous nature and associated factors
  • Include any relevant imaging studies and treatment plans

Exclusion Criteria

Do NOT use M66.271 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

28200CPT Code

Repair of ruptured tendon, extensor, foot

Clinical Scenario

Used when surgical repair is performed for a spontaneous rupture of extensor tendons.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic surgeons should ensure that the surgical report clearly states the nature of the rupture.

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 spontaneous tendon ruptures, improving the accuracy of medical records and billing.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like spontaneous tendon ruptures, improving the accuracy of medical records and billing.

Reimbursement & Billing Impact

billing.

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 ruptures?

Spontaneous ruptures occur without any identifiable trauma, often due to underlying conditions, while traumatic ruptures result from a specific injury or event.