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ICD-10 Guide
ICD-10 CodesM67.222

M67.222

Billable

Synovial hypertrophy, not elsewhere classified, left upper arm

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

Code Description

ICD-10 M67.222 is a billable code used to indicate a diagnosis of synovial hypertrophy, not elsewhere classified, left upper arm.

Key Diagnostic Point:

Synovial hypertrophy refers to the abnormal enlargement of the synovial membrane, which lines the joints and tendon sheaths. This condition can occur in various joints, including the left upper arm, and is often associated with inflammatory processes. In the context of the left upper arm, synovial hypertrophy may result from conditions such as rheumatoid arthritis, osteoarthritis, or repetitive strain injuries. Clinically, patients may present with pain, swelling, and reduced range of motion in the affected area. The hypertrophy can lead to tenosynovitis, which is inflammation of the tendon sheath, potentially resulting in tendon ruptures if left untreated. Surgical interventions may be necessary to repair damaged tendons or to remove excess synovial tissue. Accurate diagnosis and coding are essential for appropriate treatment and reimbursement, as well as for tracking the prevalence of synovial disorders in the population.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between various types of synovial disorders
  • Understanding the relationship between synovial hypertrophy and other conditions like tenosynovitis
  • Identifying the specific anatomical location for accurate coding
  • Documenting the clinical rationale for the diagnosis

Audit Risk Factors

  • Inadequate documentation of the clinical findings
  • Failure to specify the laterality of the condition
  • Lack of supporting evidence for the diagnosis
  • Misclassification of the condition as a different synovial disorder

Specialty Focus

Medical Specialties

Rheumatology

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with joint pain and swelling, particularly in the context of autoimmune diseases.

Billing Considerations

Ensure that the documentation clearly indicates the diagnosis and any associated conditions.

Orthopedics

Documentation Requirements

Surgical reports, pre-operative assessments, and post-operative follow-ups.

Common Clinical Scenarios

Patients requiring surgical intervention for tendon repair or synovial tissue removal.

Billing Considerations

Document the specific surgical procedures performed and the rationale for intervention.

Coding Guidelines

Inclusion Criteria

Use M67.222 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the diagnosis is supported by clinical documentation
  • Include any relevant imaging studies or lab results that confirm the diagnosis

Exclusion Criteria

Do NOT use M67.222 When
  • Exclude conditions that are specifically listed in the guidelines

Related ICD-10 Codes

Related CPT Codes

29806CPT Code

Arthroscopy, shoulder, surgical

Clinical Scenario

Used when performing arthroscopic surgery to address synovial hypertrophy.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic surgeons should document the extent of synovial hypertrophy and any repairs performed.

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 data collection and reimbursement processes.

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 data collection 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 synovial hypertrophy?

Synovial hypertrophy is the abnormal enlargement of the synovial membrane, often due to inflammation, leading to pain and swelling in the affected joint.

How is synovial hypertrophy diagnosed?

Diagnosis typically involves clinical examination, imaging studies, and sometimes synovial fluid analysis to assess inflammation.