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ICD-10 Guide
ICD-10 CodesM66.121

M66.121

Billable

Rupture of synovium, right elbow

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

Code Description

ICD-10 M66.121 is a billable code used to indicate a diagnosis of rupture of synovium, right elbow.

Key Diagnostic Point:

Rupture of the synovium in the right elbow 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 trauma, repetitive strain, or underlying inflammatory conditions such as rheumatoid arthritis. The synovium plays a crucial role in joint lubrication and nourishment, and its rupture can lead to joint swelling, pain, and decreased range of motion. Clinically, patients may present with localized tenderness, swelling, and signs of inflammation in the elbow region. Diagnosis typically involves a thorough physical examination, imaging studies such as MRI or ultrasound, and sometimes arthroscopy to visualize the joint. Treatment may include conservative measures like rest, ice, and anti-inflammatory medications, or surgical intervention to repair the synovium if conservative management fails. Understanding the implications of a synovial rupture is essential for effective management and rehabilitation, as it can significantly impact joint function and quality of life.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between acute and chronic conditions
  • Understanding the relationship with other synovial disorders
  • Identifying associated injuries or conditions
  • Documentation of specific symptoms and imaging findings

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the side affected
  • Lack of imaging results in the medical record
  • Inconsistent treatment documentation

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed notes on the mechanism of injury, physical examination findings, imaging results, and treatment plan.

Common Clinical Scenarios

Patients presenting with elbow pain after a fall or repetitive overhead activities.

Billing Considerations

Ensure clarity in documenting the extent of the injury and any surgical interventions performed.

Rheumatology

Documentation Requirements

Comprehensive assessment of underlying inflammatory conditions and their impact on joint health.

Common Clinical Scenarios

Patients with a history of rheumatoid arthritis presenting with acute elbow swelling.

Billing Considerations

Document any systemic symptoms and laboratory findings that may indicate an underlying rheumatologic condition.

Coding Guidelines

Inclusion Criteria

Use M66.121 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the condition's specifics, including laterality and any associated conditions
  • Include relevant clinical findings and imaging results to support the diagnosis

Exclusion Criteria

Do NOT use M66.121 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

29800CPT Code

Arthroscopy, elbow, diagnostic, with or without synovial biopsy

Clinical Scenario

Used when a patient presents with elbow pain and swelling, and imaging suggests a synovial issue.

Documentation Requirements

Document the findings from the arthroscopy and any interventions performed.

Specialty Considerations

Orthopedic surgeons should ensure detailed operative notes are available.

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 ruptures, improving the accuracy of patient records and facilitating better treatment planning.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like synovial ruptures, improving the accuracy of patient records and facilitating better treatment planning.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like synovial ruptures, improving the accuracy of patient records and facilitating better treatment planning.

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 rupture in the elbow?

Synovial rupture in the elbow can be caused by acute trauma, such as a fall or direct impact, or by chronic overuse and repetitive strain, particularly in individuals engaged in activities that require frequent elbow motion.