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ICD-10 Guide
ICD-10 CodesM67.259

M67.259

Billable

Synovial hypertrophy, not elsewhere classified, unspecified thigh

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

Code Description

ICD-10 M67.259 is a billable code used to indicate a diagnosis of synovial hypertrophy, not elsewhere classified, unspecified thigh.

Key Diagnostic Point:

Synovial hypertrophy refers to the abnormal enlargement of the synovial membrane, which lines the joints and tendon sheaths. This condition can arise from various underlying causes, including inflammatory arthritis, trauma, or chronic overuse. In the case of unspecified thigh involvement, the hypertrophy may affect the synovial structures associated with the hip or knee joints, leading to pain, swelling, and reduced range of motion. Clinically, patients may present with symptoms such as joint stiffness, tenderness, and effusion. Diagnosis typically involves imaging studies like MRI or ultrasound to visualize the synovial tissue and assess for associated conditions such as tenosynovitis or tendon ruptures. Treatment may include conservative measures such as physical therapy, corticosteroid injections, or surgical interventions to repair or remove affected tissues. Accurate coding is essential for proper management and reimbursement, as it reflects the complexity of the patient's condition and the care provided.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and underlying causes
  • Need for precise documentation of symptoms and imaging findings
  • Differentiation from other synovial disorders
  • Potential for co-existing conditions affecting coding

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to specify the joint involved
  • Misinterpretation of imaging results
  • Inconsistent treatment documentation

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed notes on joint examination, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with joint pain and swelling, particularly after injury or overuse.

Billing Considerations

Ensure documentation reflects the specific joint involved and any associated conditions.

Rheumatology

Documentation Requirements

Comprehensive assessment of inflammatory markers, patient history, and response to treatment.

Common Clinical Scenarios

Patients with chronic inflammatory conditions presenting with synovial hypertrophy.

Billing Considerations

Document any systemic symptoms or comorbidities that may influence treatment.

Coding Guidelines

Inclusion Criteria

Use M67.259 When
  • Follow official ICD
  • 10 guidelines for coding synovial disorders, ensuring to document the specific joint involved and any relevant clinical findings

Exclusion Criteria

Do NOT use M67.259 When
  • Exclude conditions that are more specifically classified under other codes

Related ICD-10 Codes

Related CPT Codes

20610CPT Code

Arthrocentesis, aspiration of a major joint or bursa

Clinical Scenario

Used when a patient presents with joint swelling and requires fluid removal.

Documentation Requirements

Document the reason for aspiration, the amount of fluid removed, and any findings.

Specialty Considerations

Orthopedic specialists should ensure detailed notes on joint examination and fluid analysis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of synovial disorders, improving the accuracy of diagnoses and treatment plans. M67.259 provides a way to capture cases of synovial hypertrophy that do not fit into more specific categories.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of synovial disorders, improving the accuracy of diagnoses and treatment plans. M67.259 provides a way to capture cases of synovial hypertrophy that do not fit into more specific categories.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of synovial disorders, improving the accuracy of diagnoses and treatment plans. M67.259 provides a way to capture cases of synovial hypertrophy that do not fit into more specific categories.

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 or mechanical stress, leading to joint pain and swelling.