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ICD-10 Guide
ICD-10 CodesM66.33

M66.33

Billable

Spontaneous rupture of flexor tendons, forearm

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

Code Description

ICD-10 M66.33 is a billable code used to indicate a diagnosis of spontaneous rupture of flexor tendons, forearm.

Key Diagnostic Point:

Spontaneous rupture of flexor tendons in the forearm is a condition characterized by the unexpected tearing of the flexor tendons, which are responsible for bending the fingers and wrist. This condition can occur without any significant trauma or injury, often seen in patients with underlying conditions such as rheumatoid arthritis, diabetes, or chronic tenosynovitis. The rupture may lead to significant functional impairment, pain, and inability to flex the fingers or wrist. Diagnosis typically involves a thorough clinical examination, imaging studies such as ultrasound or MRI, and sometimes surgical exploration. Treatment options may include surgical repair of the tendon, rehabilitation, and management of any underlying conditions. The prognosis depends on the extent of the rupture and the timing of the intervention, with early surgical repair generally leading to better outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between spontaneous and traumatic ruptures
  • Identifying underlying conditions contributing to the rupture
  • Understanding the anatomical location and specific tendon involved
  • Documenting the severity and functional impact of the rupture

Audit Risk Factors

  • Inadequate documentation of the spontaneous nature of the rupture
  • Failure to document underlying conditions contributing to the rupture
  • Lack of clarity on the surgical procedure performed
  • Inconsistent coding of related diagnoses or procedures

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative notes, imaging results, and pre-operative assessments.

Common Clinical Scenarios

Patients presenting with acute pain and inability to flex fingers after a spontaneous rupture.

Billing Considerations

Ensure documentation reflects the mechanism of injury and any pre-existing conditions.

Rheumatology

Documentation Requirements

Comprehensive history of joint and tendon issues, lab results indicating underlying conditions.

Common Clinical Scenarios

Patients with rheumatoid arthritis experiencing tendon ruptures.

Billing Considerations

Document the relationship between systemic disease and tendon integrity.

Coding Guidelines

Inclusion Criteria

Use M66.33 When
  • According to ICD
  • CM guidelines, M66
  • 33 should be used when the documentation specifies a spontaneous rupture of flexor tendons in the forearm
  • It is important to ensure that the documentation supports the diagnosis and any related procedures performed

Exclusion Criteria

Do NOT use M66.33 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

26301CPT Code

Repair of flexor tendon

Clinical Scenario

Used when surgical repair is performed following a spontaneous rupture.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic surgeons must document the extent of the repair and any complications.

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 spontaneous tendon ruptures, 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 spontaneous tendon ruptures, 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 spontaneous tendon ruptures, 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 spontaneous rupture of flexor tendons?

Spontaneous ruptures are often associated with underlying conditions such as rheumatoid arthritis, diabetes, or chronic tenosynovitis, which weaken the tendon structure over time.