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ICD-10 Guide
ICD-10 CodesM66.252

M66.252

Billable

Spontaneous rupture of extensor tendons, left thigh

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

Code Description

ICD-10 M66.252 is a billable code used to indicate a diagnosis of spontaneous rupture of extensor tendons, left thigh.

Key Diagnostic Point:

Spontaneous rupture of extensor tendons in the left thigh is a condition characterized by the unexpected tearing of the extensor tendons, which are responsible for extending the knee and stabilizing the leg during movement. This condition can occur due to various factors, including underlying degenerative changes, inflammatory processes, or acute trauma. Patients may present with sudden pain, swelling, and loss of function in the affected area. The diagnosis is typically confirmed through clinical examination and imaging studies, such as MRI, which can reveal tendon integrity and associated soft tissue injuries. Treatment often involves conservative management, including rest, ice, compression, and elevation (RICE), but may require surgical intervention for complete ruptures to restore tendon function and prevent long-term disability. Surgical options may include tendon repair or reconstruction, depending on the severity of the rupture and the patient's overall health status. Accurate coding is essential for proper reimbursement and to reflect the complexity of the condition and its management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between spontaneous and traumatic ruptures
  • Identifying the specific tendon involved
  • Understanding the implications of left-sided versus right-sided injuries
  • Documenting associated injuries or conditions

Audit Risk Factors

  • Inadequate documentation of the spontaneous nature of the rupture
  • Failure to specify the exact tendon involved
  • Lack of imaging reports to support the diagnosis
  • Inconsistent treatment documentation

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative reports, imaging studies, and pre-operative assessments are necessary.

Common Clinical Scenarios

Patients presenting with acute knee pain and swelling, particularly athletes or individuals with a history of tendonitis.

Billing Considerations

Ensure that the surgical approach and any associated procedures are clearly documented to support coding.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive evaluations including functional assessments and treatment plans.

Common Clinical Scenarios

Patients undergoing rehabilitation post-surgery or those with chronic pain due to tendon issues.

Billing Considerations

Documenting the patient's functional limitations and progress is crucial for accurate coding.

Coding Guidelines

Inclusion Criteria

Use M66.252 When
  • According to ICD
  • 10 guidelines, M66
  • 252 should be used when there is clear documentation of a spontaneous rupture of the extensor tendons in the left thigh
  • It is important to ensure that the documentation supports the diagnosis and that any associated conditions are also coded appropriately

Exclusion Criteria

Do NOT use M66.252 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27301CPT Code

Repair of tendon, extensor, thigh

Clinical Scenario

Used when surgical repair is performed for a spontaneous rupture.

Documentation Requirements

Operative report detailing the procedure, indication for surgery, and post-operative care.

Specialty Considerations

Orthopedic surgeons must document the extent of the rupture and any additional procedures performed.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of tendon injuries, improving the accuracy of claims and ensuring appropriate reimbursement for complex cases like spontaneous ruptures.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of tendon injuries, improving the accuracy of claims and ensuring appropriate reimbursement for complex cases like spontaneous ruptures.

Reimbursement & Billing Impact

reimbursement for complex cases like spontaneous ruptures.

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 difference between spontaneous and traumatic tendon rupture?

Spontaneous tendon rupture occurs without an identifiable external force, often due to underlying degenerative conditions, while traumatic rupture is the result of a specific injury or event.