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ICD-10 Guide
ICD-10 CodesM66.32

M66.32

Billable

Spontaneous rupture of flexor tendons, upper arm

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

Code Description

ICD-10 M66.32 is a billable code used to indicate a diagnosis of spontaneous rupture of flexor tendons, upper arm.

Key Diagnostic Point:

Spontaneous rupture of flexor tendons in the upper arm is a condition characterized by the unexpected tearing of the flexor tendons, which are responsible for bending the elbow and wrist. This condition can occur due to various factors, including chronic inflammation, degenerative changes, or acute trauma. Patients may present with sudden pain, swelling, and loss of function in the affected arm. The flexor tendons are typically surrounded by a synovial sheath, and conditions such as tenosynovitis can contribute to tendon weakening and eventual rupture. Diagnosis is often confirmed through physical examination and imaging studies, such as ultrasound or MRI, which can visualize tendon integrity. Treatment may involve conservative management, such as rest and physical therapy, or surgical intervention to repair the ruptured tendon, depending on the severity of the injury and the patient's functional needs.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between spontaneous and traumatic ruptures
  • Understanding associated conditions like tenosynovitis
  • Identifying the specific tendon involved
  • Documenting the clinical scenario accurately

Audit Risk Factors

  • Inadequate documentation of the spontaneous nature of the rupture
  • Failure to document associated conditions like tenosynovitis
  • Lack of clarity on the specific tendon affected
  • Inconsistent coding of surgical interventions

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed notes on the mechanism of injury, physical examination findings, and imaging results.

Common Clinical Scenarios

Patients presenting with acute pain and loss of function in the upper arm following a history of chronic pain or inflammation.

Billing Considerations

Ensure that the surgical repair details are documented if applicable, including the type of repair performed.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessment of functional limitations and rehabilitation goals.

Common Clinical Scenarios

Patients recovering from tendon repair surgery requiring rehabilitation services.

Billing Considerations

Document the patient's progress and any complications that may arise during rehabilitation.

Coding Guidelines

Inclusion Criteria

Use M66.32 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the spontaneous nature of the rupture and any associated conditions
  • Include details of the treatment plan and any surgical interventions performed

Exclusion Criteria

Do NOT use M66.32 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

26301CPT Code

Repair of flexor tendon

Clinical Scenario

Used when a surgical repair is performed for a spontaneous rupture.

Documentation Requirements

Operative report detailing the procedure, findings, and postoperative care.

Specialty Considerations

Orthopedic surgeons should ensure accurate coding of the procedure performed.

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 patient records and facilitating better treatment planning.

ICD-9 vs ICD-10

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

Reimbursement & Billing Impact

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

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 flexor tendons?

Common causes include chronic inflammation, degenerative changes, and underlying conditions such as rheumatoid arthritis or diabetes, which can weaken tendon structures.