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ICD-10 Guide
ICD-10 CodesM66.13

M66.13

Billable

Rupture of synovium, wrist

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

Code Description

ICD-10 M66.13 is a billable code used to indicate a diagnosis of rupture of synovium, wrist.

Key Diagnostic Point:

Rupture of the synovium in the wrist is a condition characterized by the tearing of the synovial membrane, which lines the joints and tendons. This membrane plays a crucial role in producing synovial fluid, which lubricates the joints and reduces friction during movement. A rupture can occur due to trauma, repetitive strain, or underlying inflammatory conditions such as rheumatoid arthritis or tenosynovitis. Patients may present with symptoms including swelling, pain, and limited range of motion in the wrist. 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 anti-inflammatory medications, or surgical intervention to repair the ruptured synovium, especially in cases where there is significant functional impairment. Post-surgical rehabilitation is often necessary to restore strength and mobility. Accurate coding of this condition is essential for proper reimbursement and tracking of treatment outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between acute and chronic ruptures
  • Identifying associated conditions like tenosynovitis
  • Understanding the implications of surgical versus non-surgical treatment
  • Documentation of specific symptoms and imaging results

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the extent of the rupture
  • Lack of imaging results in the medical record
  • Improper coding of associated conditions

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with wrist pain after a fall or repetitive use, requiring surgical intervention.

Billing Considerations

Ensure that the surgical procedure performed is clearly documented to support the coding.

Rheumatology

Documentation Requirements

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

Common Clinical Scenarios

Patients with rheumatoid arthritis experiencing acute exacerbations leading to synovial rupture.

Billing Considerations

Documenting the relationship between systemic disease and local joint pathology is crucial.

Coding Guidelines

Inclusion Criteria

Use M66.13 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used only when there is clear documentation of a rupture of the synovium in the wrist
  • Include any relevant details about associated conditions or complications

Exclusion Criteria

Do NOT use M66.13 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

29874CPT Code

Arthroscopy, wrist, with synovectomy

Clinical Scenario

Used when surgical intervention is required for a ruptured synovium.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic surgeons should ensure clear documentation of the surgical approach and any complications.

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 rupture, 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 rupture, 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 is the primary cause of synovial rupture in the wrist?

The primary causes include trauma, repetitive strain injuries, and underlying inflammatory conditions such as rheumatoid arthritis.

How can I differentiate between a synovial rupture and a tendon injury?

A synovial rupture primarily affects the synovial membrane, while a tendon injury involves the tendons themselves. Imaging studies and clinical examination can help clarify the diagnosis.