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ICD-10 Guide
ICD-10 CodesM66.871

M66.871

Billable

Spontaneous rupture of other tendons, right ankle and foot

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

Code Description

ICD-10 M66.871 is a billable code used to indicate a diagnosis of spontaneous rupture of other tendons, right ankle and foot.

Key Diagnostic Point:

Spontaneous rupture of tendons in the right ankle and foot can occur due to various factors, including underlying degenerative conditions, inflammatory processes, or acute trauma. This condition is characterized by the sudden tearing of tendons, which may lead to significant pain, swelling, and functional impairment. The tendons in the ankle and foot, such as the peroneal tendons, Achilles tendon, and others, can be affected. Patients may present with symptoms such as a 'popping' sensation at the time of injury, followed by swelling and bruising. 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 severe cases. Surgical repair aims to restore tendon integrity and function, often requiring meticulous technique to ensure optimal healing and recovery.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between spontaneous and traumatic ruptures
  • Identifying the specific tendon involved
  • Documenting the clinical presentation accurately
  • Understanding the implications of 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 studies to support the diagnosis
  • Inconsistent treatment documentation

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed clinical notes, imaging results, and treatment plans must be documented.

Common Clinical Scenarios

Patients presenting with acute ankle pain, swelling, and functional limitations.

Billing Considerations

Ensure that the mechanism of injury is clearly documented to support the diagnosis.

Physical Medicine and Rehabilitation

Documentation Requirements

Functional assessments and rehabilitation plans should be included.

Common Clinical Scenarios

Patients recovering from tendon repair surgery requiring rehabilitation.

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use M66.871 When
  • According to ICD
  • 10 guidelines, M66
  • 871 should be used when there is clear documentation of a spontaneous rupture of a tendon in the right ankle and foot
  • It is essential to ensure that the clinical documentation supports the diagnosis and that any associated conditions are also coded appropriately

Exclusion Criteria

Do NOT use M66.871 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27658CPT Code

Repair of ruptured tendon

Clinical Scenario

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

Documentation Requirements

Operative reports detailing the procedure and findings.

Specialty Considerations

Orthopedic surgeons must document the specific tendon repaired and the surgical 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 data collection and reimbursement processes. M66.871 provides a clear distinction for spontaneous ruptures, which aids in clinical research and treatment planning.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of tendon injuries, improving the accuracy of data collection and reimbursement processes. M66.871 provides a clear distinction for spontaneous ruptures, which aids in clinical research and treatment planning.

Reimbursement & Billing Impact

reimbursement processes. M66.871 provides a clear distinction for spontaneous ruptures, which aids in clinical research and treatment planning.

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 or excessive force applied to the tendon.