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ICD-10 Guide
ICD-10 CodesM66.352

M66.352

Billable

Spontaneous rupture of flexor tendons, left thigh

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

Code Description

ICD-10 M66.352 is a billable code used to indicate a diagnosis of spontaneous rupture of flexor tendons, left thigh.

Key Diagnostic Point:

Spontaneous rupture of flexor tendons in the left thigh is a condition characterized by the unexpected tearing of the flexor tendons, which are responsible for bending the knee and controlling movement in the thigh. This condition can occur due to various factors, including underlying degenerative changes, inflammatory processes, or 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 or ultrasound, which can visualize the extent of the tendon damage. Treatment often involves surgical intervention to repair the ruptured tendon, followed by rehabilitation to restore function. The prognosis varies depending on the severity of the rupture and the timeliness of the intervention. Proper coding is essential for accurate billing and to ensure that the patient's medical history reflects the severity and nature of the injury.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between spontaneous and traumatic ruptures
  • Identifying the specific tendon involved
  • Understanding the anatomical location (left thigh) for accurate coding
  • Documenting associated conditions such as tenosynovitis

Audit Risk Factors

  • Inadequate documentation of the spontaneous nature of the rupture
  • Failure to specify the tendon involved
  • Lack of imaging studies to support the diagnosis
  • Improper coding of associated conditions

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed operative notes, imaging results, and follow-up assessments are necessary.

Common Clinical Scenarios

Patients presenting with acute pain and swelling in the thigh after a sudden movement or injury.

Billing Considerations

Ensure that the surgical repair details are documented, including the type of repair performed.

Physical Therapy

Documentation Requirements

Progress notes detailing rehabilitation protocols and patient responses.

Common Clinical Scenarios

Patients undergoing rehabilitation post-surgery for tendon repair.

Billing Considerations

Document functional limitations and progress towards recovery.

Coding Guidelines

Inclusion Criteria

Use M66.352 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used only when the rupture is spontaneous and specifically in the left thigh
  • Include any relevant secondary codes for associated conditions

Exclusion Criteria

Do NOT use M66.352 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27301CPT Code

Repair of tendon, flexor, thigh

Clinical Scenario

Used when performing surgical repair of the ruptured flexor tendon in the left thigh.

Documentation Requirements

Operative report detailing the procedure performed and the condition of the tendon.

Specialty Considerations

Orthopedic surgeons should ensure accurate documentation of the surgical approach and technique.

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, including spontaneous ruptures, which enhances the accuracy of patient records and billing.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of tendon injuries, including spontaneous ruptures, which enhances the accuracy of patient records and billing.

Reimbursement & Billing Impact

billing.

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 a specific traumatic event, often due to underlying conditions, while traumatic rupture is a direct result of an injury or accident.