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ICD-10 Guide
ICD-10 CodesM66.842

M66.842

Billable

Spontaneous rupture of other tendons, left hand

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

Code Description

ICD-10 M66.842 is a billable code used to indicate a diagnosis of spontaneous rupture of other tendons, left hand.

Key Diagnostic Point:

Spontaneous rupture of tendons in the left hand can occur due to various factors, including underlying conditions such as tenosynovitis, which is the inflammation of the synovial sheath surrounding the tendon. This inflammation can weaken the tendon structure, making it more susceptible to rupture. The spontaneous rupture may present with sudden pain, swelling, and loss of function in the affected area. Diagnosis typically involves a thorough clinical examination and imaging studies, such as ultrasound or MRI, to confirm the rupture and assess the extent of damage. Treatment options may include conservative management with rest and immobilization or surgical intervention to repair the tendon, depending on the severity of the rupture and the patient's overall health. Accurate coding is essential for proper reimbursement and to reflect the complexity of the condition, especially when associated with other musculoskeletal disorders.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between spontaneous and traumatic ruptures
  • Identifying the specific tendon involved
  • Documenting associated conditions like tenosynovitis
  • Understanding the implications of surgical versus non-surgical treatment

Audit Risk Factors

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

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed notes on the mechanism of injury, imaging results, and treatment plan.

Common Clinical Scenarios

Patients presenting with acute pain and swelling in the left hand, often following repetitive use or underlying inflammatory conditions.

Billing Considerations

Ensure that all relevant imaging studies are documented and that the specific tendon involved is clearly identified.

Rheumatology

Documentation Requirements

Comprehensive history of joint and tendon issues, including any autoimmune conditions.

Common Clinical Scenarios

Patients with a history of inflammatory arthritis presenting with tendon ruptures.

Billing Considerations

Document any systemic conditions that may contribute to tendon weakness.

Coding Guidelines

Inclusion Criteria

Use M66.842 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the spontaneous nature of the rupture and any associated conditions

Exclusion Criteria

Do NOT use M66.842 When
  • Exclude conditions that may not be spontaneous in nature

Related ICD-10 Codes

Related CPT Codes

27301CPT Code

Repair of tendon, flexor, hand

Clinical Scenario

Used when surgical repair is performed for a spontaneous tendon rupture.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic surgeons should ensure that the specific tendon repaired is 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 ruptures, improving the accuracy of patient records and reimbursement processes. M66.842 provides a clear distinction for spontaneous ruptures, which aids in clinical research and treatment planning.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of tendon ruptures, improving the accuracy of patient records and reimbursement processes. M66.842 provides a clear distinction for spontaneous ruptures, which aids in clinical research and treatment planning.

Reimbursement & Billing Impact

reimbursement processes. M66.842 provides a clear distinction for spontaneous ruptures, which aids in clinical research and 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 are the common causes of spontaneous tendon rupture?

Common causes include chronic inflammatory conditions, repetitive strain injuries, and degenerative changes in the tendon due to aging or systemic diseases.