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ICD-10 Guide
ICD-10 CodesM66.839

M66.839

Billable

Spontaneous rupture of other tendons, unspecified forearm

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

Code Description

ICD-10 M66.839 is a billable code used to indicate a diagnosis of spontaneous rupture of other tendons, unspecified forearm.

Key Diagnostic Point:

Spontaneous rupture of tendons in the forearm can occur due to various factors, including underlying degenerative conditions, inflammatory processes, or sudden trauma. This condition is characterized by the unexpected tearing of tendons, which may not be associated with a specific injury or event. In the forearm, tendons such as the flexor and extensor tendons can be affected, leading to pain, swelling, and functional impairment. Patients may present with acute pain, loss of strength, and difficulty in performing daily activities. The diagnosis is often confirmed through clinical examination and imaging studies, such as ultrasound or MRI, which can visualize the extent of the rupture. Treatment may involve conservative management, including rest, ice, and physical therapy, or surgical intervention to repair the ruptured tendon, depending on the severity and functional impact of the injury. Accurate coding is essential for proper reimbursement and to reflect the complexity of the condition in clinical documentation.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of tendon rupture
  • Need for precise documentation of the spontaneous nature of the rupture
  • Differentiation from traumatic tendon injuries
  • Potential for co-existing conditions affecting tendon health

Audit Risk Factors

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

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with acute forearm pain and functional limitations without a clear history of trauma.

Billing Considerations

Ensure that the documentation clearly states the spontaneous nature of the rupture and any relevant comorbidities.

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

Document the patient's progress and response to therapy to support ongoing treatment needs.

Coding Guidelines

Inclusion Criteria

Use M66.839 When
  • Follow official coding guidelines for reporting tendon ruptures, ensuring that the documentation supports the diagnosis of spontaneous rupture
  • Include any relevant imaging findings and treatment plans

Exclusion Criteria

Do NOT use M66.839 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

24357CPT Code

Repair of tendon, forearm

Clinical Scenario

Used when surgical repair is performed for a spontaneous tendon rupture.

Documentation Requirements

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

Specialty Considerations

Orthopedic surgeons should ensure that the diagnosis aligns with the surgical procedure performed.

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 spontaneous ruptures, which enhances the accuracy of clinical documentation and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of tendon injuries, including spontaneous ruptures, which enhances the accuracy of clinical documentation 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 M66.839 and traumatic tendon rupture codes?

M66.839 specifically refers to spontaneous ruptures that occur without a clear traumatic event, while traumatic tendon rupture codes are used when there is a documented injury or event leading to the rupture.