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ICD-10 Guide
ICD-10 CodesM66.179

M66.179

Billable

Rupture of synovium, unspecified toe(s)

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

Code Description

ICD-10 M66.179 is a billable code used to indicate a diagnosis of rupture of synovium, unspecified toe(s).

Key Diagnostic Point:

Rupture of the synovium in the toe(s) refers to the tearing or disruption of the synovial membrane that surrounds the joints of the toes. This condition can occur due to trauma, repetitive stress, or underlying inflammatory conditions such as rheumatoid arthritis or gout. The synovium plays a crucial role in joint health by producing synovial fluid, which lubricates the joint and nourishes the cartilage. When the synovium is ruptured, it can lead to joint swelling, pain, and decreased mobility. Symptoms may include localized pain, swelling, and tenderness in the affected toe(s), and patients may experience difficulty in walking or bearing weight. Diagnosis typically involves a physical examination, imaging studies such as ultrasound or MRI, and sometimes aspiration of joint fluid for analysis. Treatment options may include conservative measures like rest, ice, compression, and elevation (RICE), as well as corticosteroid injections or surgical intervention in severe cases. Surgical repair may involve synovectomy or other procedures to restore joint function and alleviate pain.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and symptoms
  • Need for precise documentation of the rupture location
  • Differentiation from other synovial disorders
  • Potential for co-existing conditions affecting coding

Audit Risk Factors

  • Inadequate documentation of the rupture's cause
  • Failure to specify the affected toe(s)
  • Misclassification with other joint disorders
  • Lack of supporting imaging or clinical evidence

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 toe pain after trauma or chronic pain due to inflammatory arthritis.

Billing Considerations

Ensure clear documentation of the specific toe involved and any associated injuries.

Rheumatology

Documentation Requirements

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

Common Clinical Scenarios

Patients with autoimmune conditions presenting with joint swelling and pain.

Billing Considerations

Document any underlying rheumatologic conditions that may contribute to synovial rupture.

Coding Guidelines

Inclusion Criteria

Use M66.179 When
  • Follow official ICD
  • CM guidelines for coding injuries and conditions affecting the musculoskeletal system
  • Ensure accurate documentation of the rupture's specifics and any associated conditions

Exclusion Criteria

Do NOT use M66.179 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

28200CPT Code

Excision of a lesion of the toe

Clinical Scenario

Used when surgical intervention is required for a ruptured synovium.

Documentation Requirements

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

Specialty Considerations

Orthopedic surgeons should provide detailed operative notes.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of synovial disorders, 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 synovial disorders, 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 toe?

Synovial rupture in the toe can be caused by acute trauma, repetitive stress, or underlying inflammatory conditions such as rheumatoid arthritis or gout.