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ICD-10 Guide
ICD-10 CodesM66.262

M66.262

Billable

Spontaneous rupture of extensor tendons, left lower leg

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

Code Description

ICD-10 M66.262 is a billable code used to indicate a diagnosis of spontaneous rupture of extensor tendons, left lower leg.

Key Diagnostic Point:

Spontaneous rupture of extensor tendons in the left lower leg is a condition characterized by the unexpected tearing of the extensor tendons, which are responsible for extending the toes and foot. This injury can occur due to various factors, including underlying degenerative changes, inflammatory conditions, 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 ultrasound or MRI, which can visualize the extent of the rupture. Treatment options may include conservative management with rest and immobilization or surgical intervention to repair the torn tendon, depending on the severity of the rupture and the patient's functional needs. Post-surgical rehabilitation is crucial for restoring strength and mobility. Understanding the nuances of this condition is essential for accurate coding and appropriate management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between spontaneous and traumatic ruptures
  • Identifying the specific tendon involved
  • Understanding associated conditions like tenosynovitis
  • Documenting the severity and impact on function

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the tendon involved
  • Misclassification of spontaneous vs. traumatic rupture
  • Lack of follow-up documentation post-surgery

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative notes, imaging results, and post-operative assessments are essential.

Common Clinical Scenarios

Ruptures following chronic tendonitis or acute injuries during sports activities.

Billing Considerations

Ensure clear documentation of the surgical procedure performed and any complications.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessments of functional limitations and rehabilitation progress.

Common Clinical Scenarios

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

Billing Considerations

Documenting the patient's functional status and response to therapy is critical.

Coding Guidelines

Inclusion Criteria

Use M66.262 When
  • Follow official coding guidelines for tendon injuries, ensuring accurate documentation of the rupture's nature and location
  • Include any relevant comorbidities or associated conditions

Exclusion Criteria

Do NOT use M66.262 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27301CPT Code

Repair of tendon, extensor, lower leg

Clinical Scenario

Used when surgical repair is performed for a spontaneous rupture.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic surgeons must document the extent of the injury and repair.

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 diagnoses and treatment plans. M66.262 provides a clear distinction for spontaneous ruptures, enhancing data collection and analysis.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of tendon injuries, improving the accuracy of diagnoses and treatment plans. M66.262 provides a clear distinction for spontaneous ruptures, enhancing data collection and analysis.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of tendon injuries, improving the accuracy of diagnoses and treatment plans. M66.262 provides a clear distinction for spontaneous ruptures, enhancing data collection and analysis.

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 ruptures?

Spontaneous ruptures occur without a specific traumatic event, often due to underlying conditions, while traumatic ruptures result from direct injury or trauma.