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ICD-10 Guide
ICD-10 CodesM67.22

M67.22

Billable

Synovial hypertrophy, not elsewhere classified, upper arm

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

Code Description

ICD-10 M67.22 is a billable code used to indicate a diagnosis of synovial hypertrophy, not elsewhere classified, upper arm.

Key Diagnostic Point:

Synovial hypertrophy refers to the abnormal enlargement of the synovial membrane, which lines the joints and tendon sheaths. In the upper arm, this condition can be associated with various inflammatory and degenerative processes affecting the shoulder and elbow joints. It may arise from chronic conditions such as rheumatoid arthritis, osteoarthritis, or repetitive strain injuries. Patients often present with symptoms including joint swelling, pain, and reduced range of motion. The hypertrophy can lead to tenosynovitis, where the tendon sheaths become inflamed, causing pain and dysfunction. In severe cases, tendon ruptures may occur, necessitating surgical intervention. Surgical repairs may involve debridement, synovectomy, or tendon repair, depending on the extent of damage. Accurate diagnosis and coding are crucial for appropriate management and reimbursement, as these conditions can significantly impact a patient's quality of life and functional abilities.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between various types of synovial disorders
  • Identifying the specific location and extent of hypertrophy
  • Understanding associated conditions like tenosynovitis and tendon ruptures
  • Documenting surgical interventions accurately

Audit Risk Factors

  • Inadequate documentation of the condition's severity
  • Failure to specify associated conditions like tenosynovitis
  • Lack of clarity on surgical interventions performed
  • Misclassification of the site of hypertrophy

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed notes on the patient's history, physical examination findings, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with shoulder pain, swelling, and limited range of motion due to synovial hypertrophy.

Billing Considerations

Ensure that all associated conditions are documented to support the complexity of the case.

Rheumatology

Documentation Requirements

Comprehensive assessment of inflammatory markers, joint examination findings, and treatment response.

Common Clinical Scenarios

Patients with autoimmune disorders presenting with joint swelling and pain.

Billing Considerations

Documenting the underlying cause of synovial hypertrophy is crucial for accurate coding.

Coding Guidelines

Inclusion Criteria

Use M67.22 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used only when synovial hypertrophy is not classified elsewhere
  • Document the specific location and any associated conditions to support the diagnosis

Exclusion Criteria

Do NOT use M67.22 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

29875CPT Code

Arthroscopy, shoulder, surgical

Clinical Scenario

Used when performing arthroscopic surgery to address synovial hypertrophy in the upper arm.

Documentation Requirements

Document the indication for surgery, findings during the procedure, and any postoperative care.

Specialty Considerations

Orthopedic surgeons should ensure that the surgical necessity is well-documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like synovial hypertrophy, improving the accuracy of diagnoses and treatment plans. This specificity aids in better tracking of patient outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like synovial hypertrophy, improving the accuracy of diagnoses and treatment plans. This specificity aids in better tracking of patient outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like synovial hypertrophy, improving the accuracy of diagnoses and treatment plans. This specificity aids in better tracking of patient outcomes and resource allocation.

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 synovial hypertrophy?

Synovial hypertrophy is the abnormal thickening of the synovial membrane, often due to inflammation or mechanical stress, leading to joint swelling and pain.

When should M67.22 be used?

M67.22 should be used when documenting synovial hypertrophy in the upper arm that is not classified elsewhere, ensuring that all associated conditions are also documented.