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ICD-10 Guide
ICD-10 CodesM66.849

M66.849

Billable

Spontaneous rupture of other tendons, unspecified hand

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

Code Description

ICD-10 M66.849 is a billable code used to indicate a diagnosis of spontaneous rupture of other tendons, unspecified hand.

Key Diagnostic Point:

Spontaneous rupture of tendons in the hand can occur due to various factors, including underlying degenerative conditions, overuse, or trauma. This condition is characterized by the sudden tearing of a tendon without any external force or injury, leading to pain, swelling, and functional impairment of the affected hand. The tendons in the hand are crucial for movement and dexterity, and their rupture can significantly impact a patient's ability to perform daily activities. Commonly affected tendons include those associated with the flexor and extensor muscles. Diagnosis typically involves a thorough clinical examination, imaging studies such as ultrasound or MRI, and assessment of the patient's history. Treatment may range from conservative management, including rest and physical therapy, to surgical intervention for tendon repair, depending on the severity of the rupture and the patient's functional needs. Accurate coding is essential for proper reimbursement and to reflect the complexity of the condition in clinical documentation.

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 affected tendon and functional impairment
  • Differentiation from other tendon injuries and conditions
  • Potential for concurrent injuries requiring additional coding

Audit Risk Factors

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

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed clinical notes including mechanism of injury, physical examination findings, and imaging results.

Common Clinical Scenarios

Patients presenting with acute pain and loss of function in the hand, often after repetitive use or sudden movements.

Billing Considerations

Ensure documentation reflects the specific tendon involved and any surgical interventions performed.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessment of functional limitations and rehabilitation goals.

Common Clinical Scenarios

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

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use M66.849 When
  • Follow official coding guidelines for reporting tendon injuries, ensuring that the documentation supports the diagnosis and reflects the clinical scenario
  • Include any relevant imaging or surgical notes

Exclusion Criteria

Do NOT use M66.849 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

24357CPT Code

Repair of ruptured tendon, flexor, hand

Clinical Scenario

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

Documentation Requirements

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

Specialty Considerations

Orthopedic surgeons should ensure that the surgical notes clearly indicate the tendon repaired.

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 reflecting the complexity of these conditions. M66.849 provides a clear designation for spontaneous ruptures, which aids in clinical management and research.

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 reflecting the complexity of these conditions. M66.849 provides a clear designation for spontaneous ruptures, which aids in clinical management and research.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of tendon injuries, improving the accuracy of claims and reflecting the complexity of these conditions. M66.849 provides a clear designation for spontaneous ruptures, which aids in clinical management and research.

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 degenerative changes due to aging, chronic overuse, systemic diseases such as diabetes or rheumatoid arthritis, and sometimes genetic predispositions.

How is spontaneous tendon rupture diagnosed?

Diagnosis typically involves a clinical examination, patient history, and imaging studies such as ultrasound or MRI to confirm the rupture and assess the extent of the injury.

What treatment options are available for spontaneous tendon rupture?

Treatment options range from conservative management, including rest and physical therapy, to surgical repair, depending on the severity of the rupture and the patient's functional needs.