ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesM66.11

M66.11

Billable

Rupture of synovium, shoulder

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

Code Description

ICD-10 M66.11 is a billable code used to indicate a diagnosis of rupture of synovium, shoulder.

Key Diagnostic Point:

Rupture of the synovium in the shoulder is a condition characterized by the tearing of the synovial membrane, which lines the joint capsule and produces synovial fluid. This injury can occur due to acute trauma, repetitive stress, or underlying inflammatory conditions such as rheumatoid arthritis or tenosynovitis. Patients may present with symptoms including pain, swelling, limited range of motion, and crepitus in the shoulder joint. Diagnosis typically involves a thorough clinical examination, imaging studies such as MRI or ultrasound, and sometimes arthroscopy to visualize the joint. Treatment options may include conservative management with rest, ice, and physical therapy, or surgical intervention to repair the ruptured synovium, especially in cases where conservative measures fail. Understanding the underlying causes and associated conditions is crucial for effective management and coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between acute and chronic conditions
  • Identifying associated injuries or conditions (e.g., tendon ruptures)
  • Documentation of imaging studies and their findings
  • Variability in treatment approaches (surgical vs. conservative)

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to document associated conditions
  • Misclassification of the type of rupture (acute vs. chronic)
  • Lack of imaging documentation to support the diagnosis

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative notes, imaging results, and pre-operative assessments are essential.

Common Clinical Scenarios

Patients presenting with shoulder pain after trauma or chronic shoulder pain with limited mobility.

Billing Considerations

Ensure that all associated injuries are documented to support the complexity of the case.

Rheumatology

Documentation Requirements

Comprehensive history of joint symptoms, laboratory results, and imaging studies.

Common Clinical Scenarios

Patients with inflammatory arthritis presenting with joint effusion and pain.

Billing Considerations

Documenting the relationship between systemic conditions and local joint symptoms is crucial.

Coding Guidelines

Inclusion Criteria

Use M66.11 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the condition's severity, duration, and any associated injuries
  • Include details from imaging studies and clinical assessments

Exclusion Criteria

Do NOT use M66.11 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

29827CPT Code

Arthroscopy, shoulder, diagnostic, with or without synovial biopsy

Clinical Scenario

Used when performing arthroscopy to assess the extent of synovial damage.

Documentation Requirements

Operative report detailing findings and procedures performed.

Specialty Considerations

Orthopedic surgeons must document the rationale for arthroscopy.

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 M66.11, improving the accuracy of patient records and facilitating better tracking of treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like M66.11, improving the accuracy of patient records and facilitating better tracking of treatment outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like M66.11, improving the accuracy of patient records and facilitating better tracking of treatment outcomes.

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 rupture in the shoulder?

Common causes include acute trauma, repetitive overhead activities, and underlying inflammatory conditions such as rheumatoid arthritis.

How is a rupture of the synovium diagnosed?

Diagnosis typically involves a combination of clinical examination, imaging studies like MRI or ultrasound, and sometimes arthroscopy.