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ICD-10 Guide
ICD-10 CodesM67.261

M67.261

Billable

Synovial hypertrophy, not elsewhere classified, right lower leg

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

Code Description

ICD-10 M67.261 is a billable code used to indicate a diagnosis of synovial hypertrophy, not elsewhere classified, right lower leg.

Key Diagnostic Point:

Synovial hypertrophy refers to the abnormal enlargement of the synovial membrane, which lines the joints and tendon sheaths. In the context of the right lower leg, this condition may arise due to various underlying factors, including inflammatory processes, repetitive stress, or degenerative changes. Patients may present with symptoms such as swelling, pain, and limited range of motion in the affected area. This condition is often associated with tenosynovitis, which is the inflammation of the synovial sheath surrounding a tendon, leading to pain and discomfort during movement. Synovial hypertrophy can also be a precursor to tendon ruptures if left untreated, as the increased pressure and inflammation can weaken the tendon structure. Surgical interventions may be necessary to address severe cases, including synovectomy or tendon repair, depending on the extent of the hypertrophy and associated damage. Accurate diagnosis typically involves imaging studies such as ultrasound or MRI to assess the extent of synovial involvement and rule out other pathologies.

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.
  • Documenting the specific location and extent of hypertrophy.
  • Identifying the underlying cause of the hypertrophy for accurate coding.

Audit Risk Factors

  • Inadequate documentation of the clinical findings.
  • Failure to specify the affected tendon or joint.
  • Misclassification of the condition as a more specific diagnosis.
  • Lack of imaging studies to support the diagnosis.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed clinical notes including physical examination findings, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with joint pain, swelling, or limited mobility due to synovial hypertrophy.

Billing Considerations

Ensure that all relevant imaging studies are documented to support the diagnosis.

Rheumatology

Documentation Requirements

Comprehensive history of symptoms, laboratory tests, and response to treatment.

Common Clinical Scenarios

Patients with inflammatory arthritis presenting with synovial hypertrophy.

Billing Considerations

Document any systemic symptoms or comorbid conditions that may contribute to the hypertrophy.

Coding Guidelines

Inclusion Criteria

Use M67.261 When
  • According to ICD
  • 10 coding guidelines, M67
  • 261 should be used when synovial hypertrophy is confirmed and not classified elsewhere
  • Coders must ensure that the diagnosis is supported by clinical documentation and imaging studies

Exclusion Criteria

Do NOT use M67.261 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

20610CPT Code

Arthrocentesis, aspiration and/or injection into a major joint or bursa

Clinical Scenario

Used when aspiration of the joint is performed to relieve swelling.

Documentation Requirements

Document the indication for the procedure and the amount of fluid removed.

Specialty Considerations

Orthopedic specialists should ensure that imaging studies are available to support the need for the procedure.

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 are the common causes of synovial hypertrophy?

Common causes include inflammatory conditions such as rheumatoid arthritis, repetitive strain injuries, and degenerative joint diseases.

How is synovial hypertrophy diagnosed?

Diagnosis typically involves a combination of clinical examination, imaging studies such as ultrasound or MRI, and exclusion of other conditions.