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ICD-10 Guide
ICD-10 CodesM66.131

M66.131

Billable

Rupture of synovium, right wrist

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

Code Description

ICD-10 M66.131 is a billable code used to indicate a diagnosis of rupture of synovium, right wrist.

Key Diagnostic Point:

Rupture of the synovium in the right wrist is a condition characterized by the tearing of the synovial membrane, which lines the joints and tendon sheaths. This injury can occur due to trauma, repetitive stress, or underlying inflammatory conditions such as rheumatoid arthritis. The synovium plays a crucial role in joint health by producing synovial fluid, which lubricates the joint and nourishes the cartilage. When the synovium ruptures, it can lead to pain, swelling, and decreased range of motion in the wrist. Patients may present with symptoms such as localized tenderness, swelling, and sometimes a palpable defect in the area of the rupture. Diagnosis typically involves a thorough clinical examination and may be supported by imaging studies such as ultrasound or MRI to assess the extent of the injury. Treatment options may include conservative management with rest, ice, and anti-inflammatory medications, or surgical intervention if the rupture is severe or associated with tendon damage. Surgical repair may involve debridement of the damaged synovium and reconstruction of the surrounding structures to restore function and alleviate pain.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between types of synovial injuries
  • Understanding associated conditions like tenosynovitis
  • Identifying the specific location of the rupture
  • Documenting the severity and treatment plan accurately

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the side of the body affected
  • Lack of clarity on associated conditions like tenosynovitis
  • Inconsistent coding of surgical procedures related to the injury

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 strain injury.

Billing Considerations

Ensure that surgical notes clearly outline the procedure performed and the findings during surgery.

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

Document the relationship between systemic disease and local joint pathology.

Coding Guidelines

Inclusion Criteria

Use M66.131 When
  • According to ICD
  • 10 guidelines, M66
  • 131 should be used when there is a confirmed rupture of the synovium in the right wrist
  • It is important to document the cause of the rupture and any associated conditions

Exclusion Criteria

Do NOT use M66.131 When
  • Exclusions include conditions that do not involve a rupture of the synovium

Related ICD-10 Codes

Related CPT Codes

29874CPT Code

Arthroscopy, wrist, diagnostic, with or without synovial biopsy

Clinical Scenario

Used when a patient with a suspected synovial rupture undergoes arthroscopy for diagnosis and potential repair.

Documentation Requirements

Document the findings during the procedure and any interventions performed.

Specialty Considerations

Orthopedic surgeons should ensure that the procedure notes detail the extent of the rupture.

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 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 rupture, 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 rupture, 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?

Synovial rupture can be caused by acute trauma, such as a fall or direct impact, or by chronic conditions that weaken the synovial membrane, such as rheumatoid arthritis.