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ICD-10 Guide
ICD-10 CodesM66.339

M66.339

Billable

Spontaneous rupture of flexor tendons, unspecified forearm

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

Code Description

ICD-10 M66.339 is a billable code used to indicate a diagnosis of spontaneous rupture of flexor tendons, unspecified 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 injury can occur without any apparent trauma or overuse, often seen in individuals with underlying conditions such as rheumatoid arthritis, diabetes, or chronic tenosynovitis. The flexor tendons are encased in a synovial sheath that can become inflamed, leading to tenosynovitis, which may weaken the tendon structure. Symptoms typically include sudden pain, swelling, and loss of function in the affected hand or wrist. Diagnosis is often confirmed through physical examination and imaging studies, such as ultrasound or MRI, to assess tendon integrity. Treatment may involve conservative management, including rest and splinting, or surgical intervention to repair the ruptured tendon, depending on the severity and functional demands of the patient. Accurate coding is essential for appropriate reimbursement and tracking of treatment outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of tendon rupture
  • Need for precise documentation of the mechanism of injury
  • Differentiation from other tendon injuries and conditions
  • Potential for co-existing conditions affecting treatment and coding

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the side of the injury
  • Lack of imaging studies to support diagnosis
  • Inconsistent documentation of treatment plans

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative reports, imaging studies, and post-operative notes.

Common Clinical Scenarios

Patients presenting with acute pain and loss of function in the hand, often following a history of chronic tendonitis.

Billing Considerations

Ensure clear documentation of the surgical approach and any complications encountered during the procedure.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessments of functional limitations and rehabilitation plans.

Common Clinical Scenarios

Patients requiring rehabilitation post-surgery or those with chronic pain and dysfunction due to tendon rupture.

Billing Considerations

Document the patient's progress and response to therapy to support ongoing treatment needs.

Coding Guidelines

Inclusion Criteria

Use M66.339 When
  • Follow official ICD
  • 10 coding guidelines, ensuring that the code is used only when the condition is confirmed and documented
  • Include any relevant co
  • morbidities and specify the side of the injury when applicable

Exclusion Criteria

Do NOT use M66.339 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

26301CPT Code

Repair of flexor tendon

Clinical Scenario

Used when surgical repair of the ruptured tendon is performed.

Documentation Requirements

Operative report detailing the procedure, findings, and post-operative care.

Specialty Considerations

Orthopedic surgeons should ensure that the surgical approach and any complications are well-documented.

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 facilitating better tracking of treatment outcomes. M66.339 provides a clear designation for spontaneous ruptures, aiding in clinical research and quality improvement initiatives.

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 facilitating better tracking of treatment outcomes. M66.339 provides a clear designation for spontaneous ruptures, aiding in clinical research and quality improvement initiatives.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of tendon injuries, improving the accuracy of claims and facilitating better tracking of treatment outcomes. M66.339 provides a clear designation for spontaneous ruptures, aiding in clinical research and quality improvement initiatives.

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 are the common causes of spontaneous rupture of flexor tendons?

Common causes include underlying conditions such as rheumatoid arthritis, diabetes, chronic tenosynovitis, and degenerative changes in the tendon structure.