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ICD-10 Guide
ICD-10 CodesM67.269

M67.269

Billable

Synovial hypertrophy, not elsewhere classified, unspecified lower leg

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

Code Description

ICD-10 M67.269 is a billable code used to indicate a diagnosis of synovial hypertrophy, not elsewhere classified, unspecified lower leg.

Key Diagnostic Point:

Synovial hypertrophy refers to the abnormal enlargement of the synovial membrane, which lines the joints and tendon sheaths. This condition can lead to increased synovial fluid production, resulting in swelling and discomfort in the affected area. In the lower leg, synovial hypertrophy may be associated with various underlying conditions, including inflammatory arthritis, repetitive strain injuries, or tenosynovitis. Tenosynovitis, an inflammation of the synovial sheath surrounding a tendon, can occur in conjunction with synovial hypertrophy, particularly in the context of overuse or trauma. Patients may present with localized pain, swelling, and reduced range of motion. Surgical interventions, such as synovectomy or tendon repair, may be necessary in severe cases, especially if there is a risk of tendon rupture or chronic pain. Accurate diagnosis often requires imaging studies, such as ultrasound or MRI, to assess the extent of synovial hypertrophy and any associated tendon pathology. Treatment typically involves a combination of rest, physical therapy, and possibly corticosteroid injections to reduce inflammation.

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 the relationship with tenosynovitis and tendon injuries
  • Documenting the clinical rationale for surgical interventions

Audit Risk Factors

  • Insufficient documentation of the underlying cause of synovial hypertrophy
  • Failure to specify the exact location of the condition
  • Inadequate linkage between diagnosis and treatment provided
  • Use of unspecified codes without clear justification

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, and limited mobility due to synovial hypertrophy.

Billing Considerations

Ensure that all surgical interventions are well-documented, including indications for surgery and post-operative care.

Rheumatology

Documentation Requirements

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

Common Clinical Scenarios

Patients with autoimmune conditions presenting with synovial hypertrophy as part of their disease process.

Billing Considerations

Documenting the relationship between systemic conditions and localized synovial changes is crucial.

Coding Guidelines

Inclusion Criteria

Use M67.269 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used only when the condition is not classified elsewhere
  • Document the clinical findings that support the diagnosis and any relevant treatments

Exclusion Criteria

Do NOT use M67.269 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 joint fluid is necessary due to synovial hypertrophy.

Documentation Requirements

Document the indication for the procedure, the amount of fluid aspirated, and any findings.

Specialty Considerations

Orthopedic specialists should ensure that the procedure is justified based on clinical findings.

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 data collection and reimbursement processes. M67.269 provides a means 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 data collection and reimbursement processes. M67.269 provides a means to capture cases of synovial hypertrophy that do not fit into more specific categories.

Reimbursement & Billing Impact

reimbursement processes. M67.269 provides a means 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 the primary cause of synovial hypertrophy?

Synovial hypertrophy is primarily caused by inflammation, which can result from various conditions such as arthritis, repetitive strain, or trauma.

How is synovial hypertrophy diagnosed?

Diagnosis typically involves a combination of clinical examination, imaging studies like ultrasound or MRI, and laboratory tests to rule out other conditions.