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ICD-10 Guide
ICD-10 CodesM66.34

M66.34

Billable

Spontaneous rupture of flexor tendons, hand

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

Code Description

ICD-10 M66.34 is a billable code used to indicate a diagnosis of spontaneous rupture of flexor tendons, hand.

Key Diagnostic Point:

Spontaneous rupture of flexor tendons in the hand is a condition characterized by the unexpected tearing of the flexor tendons, which are responsible for bending the fingers. This rupture can occur without any apparent trauma or injury, often associated with underlying conditions such as rheumatoid arthritis or tenosynovitis. The flexor tendons are encased in a synovial sheath that allows for smooth movement; however, inflammation or degeneration can weaken these tendons, leading to rupture. Symptoms typically include sudden pain, swelling, and an inability to flex the affected fingers. Diagnosis is often confirmed through physical examination and imaging studies, such as ultrasound or MRI, which can visualize tendon integrity. Treatment may involve surgical repair of the ruptured tendon, followed by rehabilitation to restore function. Understanding the underlying causes and appropriate management strategies is crucial for optimal patient outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between spontaneous and traumatic ruptures
  • Identifying underlying conditions such as tenosynovitis
  • Documenting the specific tendon involved
  • Understanding the surgical repair procedures

Audit Risk Factors

  • Inadequate documentation of the spontaneous nature of the rupture
  • Failure to document underlying conditions
  • Incorrect coding of the specific tendon involved
  • Lack of clarity in surgical procedure documentation

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative reports, pre-operative assessments, and post-operative follow-ups.

Common Clinical Scenarios

Surgical repair of ruptured flexor tendons following spontaneous rupture.

Billing Considerations

Ensure clear documentation of the surgical technique and any complications.

Rheumatology

Documentation Requirements

Comprehensive patient history, including any autoimmune conditions and their management.

Common Clinical Scenarios

Management of patients with rheumatoid arthritis experiencing tendon ruptures.

Billing Considerations

Document the relationship between underlying rheumatologic conditions and tendon integrity.

Coding Guidelines

Inclusion Criteria

Use M66.34 When
  • Follow official coding guidelines for tendon injuries, ensuring accurate documentation of the spontaneous nature of the rupture
  • Include any relevant underlying conditions that may affect treatment

Exclusion Criteria

Do NOT use M66.34 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

26340CPT Code

Repair of flexor tendon

Clinical Scenario

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

Documentation Requirements

Operative report detailing the procedure and any complications.

Specialty Considerations

Orthopedic surgeons must document the specific tendon repaired and the surgical technique used.

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. M66.34 provides a clear distinction for spontaneous ruptures, enhancing data collection and analysis.

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. M66.34 provides a clear distinction for spontaneous ruptures, enhancing data collection and analysis.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of tendon injuries, improving the accuracy of diagnoses and treatment plans. M66.34 provides a clear distinction for spontaneous ruptures, enhancing data collection and analysis.

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 underlying conditions such as rheumatoid arthritis, tenosynovitis, and degenerative changes in the tendon due to repetitive stress or aging.