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v1.0.0
ICD-10 Guide
ICD-10 CodesM66.83

M66.83

Billable

Spontaneous rupture of other tendons, forearm

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

Code Description

ICD-10 M66.83 is a billable code used to indicate a diagnosis of spontaneous rupture of other tendons, forearm.

Key Diagnostic Point:

Spontaneous rupture of tendons in the forearm is a condition characterized by the unexpected tearing of tendons without any significant trauma or injury. This condition can occur due to various factors, including degenerative changes, chronic inflammation, or underlying systemic diseases. The forearm contains several important tendons, including those associated with the flexor and extensor muscles, which are crucial for wrist and finger movements. Patients may present with sudden pain, swelling, and loss of function in the affected area. The diagnosis is typically made through clinical evaluation and imaging studies, such as ultrasound or MRI, which can reveal the extent of the rupture. Treatment options may include conservative management with rest and physical therapy or surgical intervention to repair the torn tendon, depending on the severity of the rupture and the patient's functional needs. Accurate coding for spontaneous tendon ruptures is essential for proper reimbursement and tracking of treatment outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between spontaneous and traumatic ruptures
  • Identifying the specific tendon involved
  • Understanding the underlying causes of tendon rupture
  • Documenting the clinical presentation and treatment plan

Audit Risk Factors

  • Inadequate documentation of the spontaneous nature of the rupture
  • Failure to specify the tendon involved
  • Lack of imaging studies to support the diagnosis
  • Inconsistent treatment documentation

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed notes on the mechanism of injury, imaging results, and treatment plan.

Common Clinical Scenarios

Patients presenting with sudden onset pain in the forearm, often after repetitive use or in the context of systemic conditions.

Billing Considerations

Ensure that the specific tendon involved is clearly documented to avoid coding errors.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessment of functional limitations and rehabilitation goals.

Common Clinical Scenarios

Patients requiring rehabilitation post-surgery for tendon repair or those undergoing conservative management.

Billing Considerations

Documenting the patient's progress and response to therapy is crucial for accurate coding.

Coding Guidelines

Inclusion Criteria

Use M66.83 When
  • According to ICD
  • 10 guidelines, M66
  • 83 should be used when there is clear documentation of a spontaneous rupture of a tendon in the forearm
  • It is important to ensure that the documentation supports the diagnosis and that any associated conditions are coded appropriately

Exclusion Criteria

Do NOT use M66.83 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

23470CPT Code

Repair of ruptured tendon

Clinical Scenario

Used when 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. M66.83 provides a distinct code for spontaneous ruptures, which was less clearly defined in ICD-9.

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. M66.83 provides a distinct code for spontaneous ruptures, which was less clearly defined in ICD-9.

Reimbursement & Billing Impact

reimbursement processes. M66.83 provides a distinct code for spontaneous ruptures, which was less clearly defined in ICD-9.

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 tendon rupture?

Common causes include degenerative changes due to aging, chronic inflammatory conditions, and systemic diseases such as diabetes or rheumatoid arthritis.

How can I ensure accurate coding for spontaneous tendon ruptures?

Accurate coding requires detailed documentation of the clinical presentation, imaging results, and the specific tendon involved. Ensure that the nature of the rupture (spontaneous vs. traumatic) is clearly stated.