Spontaneous rupture of unspecified tendon
ICD-10 M66.9 is a billable code used to indicate a diagnosis of spontaneous rupture of unspecified tendon.
Spontaneous rupture of a tendon refers to the sudden tearing of a tendon without any apparent external trauma. This condition can occur in various tendons throughout the body, often associated with underlying conditions such as chronic inflammation, degeneration, or systemic diseases. The most commonly affected tendons include those in the shoulder (e.g., rotator cuff), Achilles tendon, and biceps tendon. Patients may present with acute pain, swelling, and loss of function in the affected area. 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 complete ruptures. The spontaneous nature of the rupture often complicates the clinical picture, as it may be mistaken for other acute injuries, necessitating careful evaluation and documentation to ensure accurate coding and appropriate management.
Detailed clinical notes including mechanism of injury, imaging results, and treatment plan.
Patients presenting with acute shoulder pain, sudden onset of weakness in the arm, or calf pain after minimal activity.
Ensure clear documentation of the spontaneous nature and any underlying conditions contributing to tendon degeneration.
Comprehensive assessment of systemic conditions that may predispose to tendon rupture, including lab results.
Patients with autoimmune disorders presenting with tendon pain and swelling.
Document any relevant systemic conditions that may affect tendon integrity.
Used when surgical intervention is required for a spontaneous rotator cuff rupture.
Operative report detailing the procedure and findings.
Orthopedic documentation must include pre-operative assessments and post-operative care plans.
M66.9 refers to spontaneous rupture of an unspecified tendon, while M66.1 specifically denotes spontaneous rupture of the biceps tendon. Accurate coding requires specifying the tendon involved when possible.