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ICD-10 Guide
ICD-10 CodesM67.28

M67.28

Billable

Synovial hypertrophy, not elsewhere classified, other site

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

Code Description

ICD-10 M67.28 is a billable code used to indicate a diagnosis of synovial hypertrophy, not elsewhere classified, other site.

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 sites throughout the body and is often associated with inflammatory processes, such as rheumatoid arthritis or other forms of arthritis. Synovial hypertrophy can lead to pain, swelling, and reduced range of motion in affected joints. It may also be a contributing factor to tenosynovitis, which is the inflammation of the synovial sheath surrounding a tendon. In cases where the hypertrophy is significant, it can result in tendon ruptures due to increased pressure on the tendon itself. Surgical interventions, such as synovectomy or tendon repair, may be necessary to alleviate symptoms and restore function. Accurate diagnosis often requires imaging studies and clinical evaluation to differentiate synovial hypertrophy from other joint pathologies. Treatment may include corticosteroid injections, physical therapy, and in some cases, surgical repair of damaged tendons or removal of hypertrophied tissue.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and underlying causes
  • Need for precise documentation of the site and extent of hypertrophy
  • Differentiation from other synovial disorders
  • Potential for co-existing conditions that complicate coding

Audit Risk Factors

  • Inadequate documentation of the specific site of hypertrophy
  • Failure to document co-existing conditions
  • Lack of clarity on the relationship between hypertrophy and tendon injuries
  • Inconsistent coding of surgical procedures related to the condition

Specialty Focus

Medical Specialties

Rheumatology

Documentation Requirements

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

Common Clinical Scenarios

Patients with rheumatoid arthritis presenting with joint swelling and pain.

Billing Considerations

Ensure clear documentation of the relationship between synovial hypertrophy and systemic inflammatory conditions.

Orthopedic Surgery

Documentation Requirements

Surgical reports detailing the procedure performed, findings, and post-operative care.

Common Clinical Scenarios

Patients undergoing tendon repair due to rupture associated with synovial hypertrophy.

Billing Considerations

Document the extent of synovial involvement and any additional procedures performed.

Coding Guidelines

Inclusion Criteria

Use M67.28 When
  • According to ICD
  • 10 guidelines, M67
  • 28 should be used when synovial hypertrophy is documented but does not fit into other specified categories
  • Coders must ensure that the documentation supports the diagnosis and that the site of hypertrophy is clearly indicated

Exclusion Criteria

Do NOT use M67.28 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

29875CPT Code

Arthroscopy, knee, diagnostic, with or without synovial biopsy

Clinical Scenario

Used when a patient with synovial hypertrophy undergoes arthroscopy for evaluation.

Documentation Requirements

Document the findings during the procedure and any biopsies taken.

Specialty Considerations

Orthopedic surgeons should ensure that the indication for surgery is clearly 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 data collection and reimbursement processes. This specificity helps in better tracking of treatment outcomes and resource utilization.

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. This specificity helps in better tracking of treatment outcomes and resource utilization.

Reimbursement & Billing Impact

reimbursement processes. This specificity helps in better tracking of treatment outcomes and resource utilization.

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 chronic inflammation, often associated with autoimmune conditions like rheumatoid arthritis, but can also result from repetitive stress or injury.