ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesM66.861

M66.861

Billable

Spontaneous rupture of other tendons, right lower leg

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

Code Description

ICD-10 M66.861 is a billable code used to indicate a diagnosis of spontaneous rupture of other tendons, right lower leg.

Key Diagnostic Point:

Spontaneous rupture of tendons in the right lower leg can occur due to various factors, including underlying degenerative conditions, acute trauma, or chronic overuse. This condition is characterized by the sudden tearing of tendons, which may lead to significant pain, swelling, and functional impairment. The tendons in the lower leg, such as the Achilles tendon or peroneal tendons, are particularly susceptible to rupture due to their role in weight-bearing and movement. Patients may present with acute pain, a palpable defect in the tendon, and difficulty in ambulation. Diagnostic imaging, such as ultrasound or MRI, may be utilized to confirm the diagnosis and assess the extent of the injury. Treatment often involves conservative management, including rest, ice, compression, and elevation (RICE), followed by physical therapy. In some cases, surgical intervention may be necessary to repair the ruptured tendon, especially if there is a complete rupture or if conservative measures fail to provide relief. 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

  • Differentiating between spontaneous and traumatic ruptures
  • Identifying the specific tendon involved
  • Documenting the severity and impact on function
  • Understanding associated conditions like tenosynovitis

Audit Risk Factors

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

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed clinical notes, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with acute pain and swelling in the lower leg, often after a sudden movement.

Billing Considerations

Ensure documentation reflects the mechanism of injury and any prior tendon issues.

Physical Medicine and Rehabilitation

Documentation Requirements

Functional assessments and rehabilitation plans.

Common Clinical Scenarios

Patients recovering from tendon repair or those undergoing conservative management.

Billing Considerations

Document progress and response to therapy to support ongoing treatment.

Coding Guidelines

Inclusion Criteria

Use M66.861 When
  • Follow official ICD
  • 10 guidelines for coding tendon injuries, ensuring accurate documentation of the spontaneous rupture and any associated conditions
  • Include relevant clinical details to support the diagnosis

Exclusion Criteria

Do NOT use M66.861 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27658CPT Code

Repair of tendon, primary, open

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 and the technique used.

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 claims and facilitating better patient care through detailed documentation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of tendon injuries, improving the accuracy of claims and facilitating better patient care through detailed documentation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of tendon injuries, improving the accuracy of claims and facilitating better patient care through detailed documentation.

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 degeneration, while traumatic rupture is the result of a specific injury or accident.