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v1.0.0
ICD-10 Guide
ICD-10 CodesM66.172

M66.172

Billable

Rupture of synovium, left ankle

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

Code Description

ICD-10 M66.172 is a billable code used to indicate a diagnosis of rupture of synovium, left ankle.

Key Diagnostic Point:

Rupture of the synovium in the left ankle refers to the tearing or disruption of the synovial membrane, which is a thin layer of tissue that lines the joints and produces synovial fluid. This condition can result from acute trauma, repetitive stress, or underlying inflammatory conditions such as rheumatoid arthritis or gout. Symptoms typically include localized swelling, pain, and reduced range of motion in the affected ankle. Diagnosis is often confirmed through imaging studies such as MRI or ultrasound, which can visualize the extent of the rupture and any associated joint effusion. Treatment may involve conservative measures such as rest, ice, compression, and elevation (RICE), as well as physical therapy. In more severe cases, surgical intervention may be required to repair the synovium or address any underlying issues. Accurate coding is essential for proper reimbursement and to reflect the complexity of the patient's condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between acute and chronic conditions
  • Identifying associated injuries or conditions
  • Understanding the implications of surgical versus non-surgical treatment
  • Navigating documentation requirements for various specialties

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the laterality of the condition
  • Lack of imaging studies to support the diagnosis
  • Improper linkage of diagnosis to treatment procedures

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Acute ankle injuries in athletes, chronic pain in older adults, post-surgical follow-ups.

Billing Considerations

Orthopedic documentation must clearly outline the extent of the injury and any surgical interventions performed.

Rheumatology

Documentation Requirements

Comprehensive history of joint symptoms, laboratory results, and treatment plans.

Common Clinical Scenarios

Patients with inflammatory arthritis presenting with joint swelling and pain.

Billing Considerations

Rheumatology notes should include details on the patient's overall disease management and any systemic implications.

Coding Guidelines

Inclusion Criteria

Use M66.172 When
  • Follow official ICD
  • CM guidelines for coding injuries, ensuring accurate documentation of laterality and specificity
  • Include any relevant external cause codes if applicable

Exclusion Criteria

Do NOT use M66.172 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

29875CPT Code

Arthroscopy, ankle, diagnostic, with or without synovial biopsy

Clinical Scenario

Used when a patient presents with a suspected synovial rupture requiring further evaluation.

Documentation Requirements

Document the indication for the procedure and findings during the arthroscopy.

Specialty Considerations

Orthopedic surgeons must ensure that the procedure is justified based on clinical findings.

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 reimbursement processes.

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 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 treatment for a rupture of the synovium?

Initial treatment typically involves conservative measures such as rest, ice, compression, and elevation (RICE). If symptoms persist or worsen, surgical intervention may be necessary.