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ICD-10 Guide
ICD-10 CodesM66.371

M66.371

Billable

Spontaneous rupture of flexor tendons, right ankle and foot

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

Code Description

ICD-10 M66.371 is a billable code used to indicate a diagnosis of spontaneous rupture of flexor tendons, right ankle and foot.

Key Diagnostic Point:

Spontaneous rupture of flexor tendons in the right ankle and foot is a condition characterized by the unexpected tearing of the flexor tendons, which are responsible for bending the toes and foot. This condition can occur due to various factors, including underlying degenerative changes, inflammatory processes, or acute trauma. Patients may present with sudden pain, swelling, and loss of function in the affected area. The flexor tendons are encased in a synovial sheath, and conditions such as tenosynovitis can predispose these tendons to rupture. Diagnosis typically involves a thorough clinical examination, imaging studies such as ultrasound or MRI, and sometimes surgical exploration. Treatment may involve surgical repair of the ruptured tendon, followed by rehabilitation to restore function. Accurate coding is essential for proper reimbursement and tracking of healthcare outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

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

Audit Risk Factors

  • Inadequate documentation of the spontaneous nature of the rupture
  • Failure to specify the exact tendon involved
  • Lack of imaging studies to support the diagnosis
  • Improper linkage of surgical procedures to the diagnosis

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

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

Common Clinical Scenarios

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

Billing Considerations

Ensure that the surgical notes clearly indicate the nature of the rupture and the repair performed.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive evaluation reports, treatment plans, and progress notes.

Common Clinical Scenarios

Patients undergoing rehabilitation post-surgery for tendon repair.

Billing Considerations

Document functional limitations and progress towards rehabilitation goals.

Coding Guidelines

Inclusion Criteria

Use M66.371 When
  • Follow official ICD
  • CM coding guidelines, ensuring that the diagnosis is supported by clinical documentation
  • Include any relevant history of tenosynovitis or other pre
  • existing conditions

Exclusion Criteria

Do NOT use M66.371 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 tendon rupture.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic surgeons must document the specific tendon repaired.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of tendon ruptures, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of tendon ruptures, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 a specific traumatic event, often due to underlying conditions, while traumatic rupture is a direct result of an injury.