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ICD-10 Guide
ICD-10 CodesM66.831

M66.831

Billable

Spontaneous rupture of other tendons, right forearm

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

Code Description

ICD-10 M66.831 is a billable code used to indicate a diagnosis of spontaneous rupture of other tendons, right forearm.

Key Diagnostic Point:

Spontaneous rupture of tendons in the right forearm can occur due to various factors, including underlying degenerative conditions, overuse, or acute trauma. This condition is characterized by the sudden tearing of tendons, which may lead to significant pain, swelling, and loss of function in the affected area. The tendons in the forearm, such as the flexor and extensor tendons, are crucial for wrist and finger movements. Patients may present with symptoms such as a 'popping' sensation at the time of injury, followed by immediate pain and difficulty in performing daily activities. Diagnosis typically involves a thorough clinical examination and imaging studies, such as ultrasound or MRI, to confirm the rupture and assess the extent of the injury. Treatment options may vary from conservative management, including rest and physical therapy, to surgical intervention for tendon repair, depending on the severity of the rupture and the patient's functional needs. Accurate coding is essential for proper reimbursement and to reflect the complexity of the condition and its management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of tendon ruptures
  • Need for precise documentation of the specific tendon involved
  • Differentiation from other tendon injuries and conditions
  • Potential for surgical versus non-surgical treatment coding

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the exact tendon involved
  • Lack of imaging studies to support the diagnosis
  • Inconsistent coding of associated procedures

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with acute pain and functional impairment after a fall or repetitive strain.

Billing Considerations

Ensure clear documentation of the tendon involved and the surgical technique used if repair is performed.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive evaluation notes, treatment plans, and progress reports.

Common Clinical Scenarios

Patients undergoing rehabilitation post-surgery or those managed conservatively.

Billing Considerations

Document functional limitations and response to therapy to support ongoing treatment.

Coding Guidelines

Inclusion Criteria

Use M66.831 When
  • Follow official ICD
  • CM coding guidelines, ensuring accurate documentation of the injury's nature and location
  • Include any relevant comorbidities and specify if the rupture is spontaneous or due to trauma

Exclusion Criteria

Do NOT use M66.831 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

24357CPT Code

Repair of ruptured tendon, forearm

Clinical Scenario

Used when surgical repair is performed for spontaneous tendon rupture.

Documentation Requirements

Operative report detailing the procedure, tendon involved, and post-operative care.

Specialty Considerations

Orthopedic surgeons must document the surgical approach and any complications.

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. M66.831 provides granularity that was not available in ICD-9, facilitating better patient care and reimbursement processes.

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. M66.831 provides granularity that was not available in ICD-9, facilitating better patient care 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 degeneration, while traumatic rupture results from a specific injury or impact.