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ICD-10 Guide
ICD-10 CodesM66.342

M66.342

Billable

Spontaneous rupture of flexor tendons, left hand

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

Code Description

ICD-10 M66.342 is a billable code used to indicate a diagnosis of spontaneous rupture of flexor tendons, left hand.

Key Diagnostic Point:

Spontaneous rupture of flexor tendons in the left 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 rupture may lead to significant functional impairment, including loss of grip strength and inability to flex the fingers. Patients may present with sudden pain, swelling, and a noticeable inability to flex the affected fingers. Diagnosis typically involves a thorough clinical examination and may be supported by imaging studies such as ultrasound or MRI to confirm the rupture. Treatment often requires surgical intervention to repair the torn tendons, followed by rehabilitation to restore function. The prognosis depends on the extent of the injury and the timing of the surgical repair.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

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

Audit Risk Factors

  • Inadequate documentation of the spontaneous nature of the rupture
  • Failure to document associated conditions like rheumatoid arthritis
  • Misclassification of the injury type (spontaneous vs. traumatic)
  • Lack of detailed operative reports for surgical repairs

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

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

Common Clinical Scenarios

Repair of ruptured flexor tendons following spontaneous rupture, management of post-operative complications.

Billing Considerations

Ensure clear documentation of the surgical technique used and any complications encountered during the procedure.

Physical Therapy

Documentation Requirements

Progress notes detailing rehabilitation protocols and patient responses.

Common Clinical Scenarios

Rehabilitation following surgical repair of flexor tendons, assessment of functional recovery.

Billing Considerations

Document specific exercises and patient compliance to support billing for therapy sessions.

Coding Guidelines

Inclusion Criteria

Use M66.342 When
  • According to ICD
  • 10 guidelines, M66
  • 342 should be used when there is clear documentation of a spontaneous rupture of flexor tendons in the left hand
  • It is important to ensure that the documentation specifies the left hand and the spontaneous nature of the rupture

Exclusion Criteria

Do NOT use M66.342 When
  • Exclusions include traumatic ruptures, which should be coded differently

Related ICD-10 Codes

Related CPT Codes

26301CPT Code

Repair of flexor tendon

Clinical Scenario

Used when performing surgical repair of a ruptured flexor tendon in the left hand.

Documentation Requirements

Operative report detailing the procedure, including the type of repair and any complications.

Specialty Considerations

Orthopedic surgeons should ensure that the surgical technique is well documented to support the coding.

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, including the differentiation between spontaneous and traumatic ruptures, which enhances the accuracy of patient records and billing.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of tendon injuries, including the differentiation between spontaneous and traumatic ruptures, which enhances the accuracy of patient 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 M66.342 and M66.341?

M66.342 refers specifically to spontaneous rupture of flexor tendons in the left hand, while M66.341 pertains to the right hand. Accurate coding requires specifying the laterality.