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ICD-10 Guide
ICD-10 CodesM66.341

M66.341

Billable

Spontaneous rupture of flexor tendons, right hand

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

Code Description

ICD-10 M66.341 is a billable code used to indicate a diagnosis of spontaneous rupture of flexor tendons, right hand.

Key Diagnostic Point:

Spontaneous rupture of flexor tendons in the right hand is a condition characterized by the unexpected tearing of the flexor tendons, which are responsible for bending the fingers. This condition can occur without any apparent trauma or injury, often seen in individuals with underlying conditions such as rheumatoid arthritis or diabetes. The flexor tendons are located within the synovial sheath, which provides lubrication and facilitates smooth movement. When these tendons rupture, patients may experience sudden pain, swelling, and loss of function in the affected fingers. Diagnosis typically involves a physical examination and imaging studies, such as ultrasound or MRI, to confirm the rupture and assess the extent of the injury. Treatment may include surgical repair of the tendon, followed by rehabilitation to restore function. The prognosis varies depending on the severity of the rupture and the timeliness of intervention.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between spontaneous and traumatic ruptures
  • Understanding the anatomical specifics of the flexor tendons
  • Identifying associated conditions that may complicate coding
  • Navigating documentation requirements for surgical interventions

Audit Risk Factors

  • Inadequate documentation of the spontaneous nature of the rupture
  • Failure to document associated conditions like diabetes or rheumatoid arthritis
  • Lack of imaging studies to support the diagnosis
  • Incorrect coding of the hand's specific anatomical location

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

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

Common Clinical Scenarios

Surgical repair of ruptured flexor tendons following spontaneous rupture.

Billing Considerations

Ensure documentation reflects the spontaneous nature and any underlying conditions.

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 health.

Coding Guidelines

Inclusion Criteria

Use M66.341 When
  • Follow official ICD
  • CM guidelines for coding tendon injuries, ensuring specificity in the location and nature of the rupture
  • Include any relevant co
  • morbidities

Exclusion Criteria

Do NOT use M66.341 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 following a spontaneous rupture.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic surgeons must document the nature of the rupture and any complications.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding tendon injuries, improving the accuracy of data collection and reimbursement processes for spontaneous ruptures.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding tendon injuries, improving the accuracy of data collection and reimbursement processes for spontaneous ruptures.

Reimbursement & Billing Impact

reimbursement processes for spontaneous ruptures.

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