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ICD-10 Guide
ICD-10 CodesM66.852

M66.852

Billable

Spontaneous rupture of other tendons, left thigh

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

Code Description

ICD-10 M66.852 is a billable code used to indicate a diagnosis of spontaneous rupture of other tendons, left thigh.

Key Diagnostic Point:

Spontaneous rupture of tendons in the left thigh can occur due to various factors, including underlying degenerative changes, systemic diseases, or acute trauma. This condition is characterized by the sudden tearing of tendons, which may lead to significant pain, swelling, and functional impairment. The tendons in the thigh, such as the quadriceps or hamstring tendons, are particularly susceptible to rupture due to their role in movement and weight-bearing activities. Patients may present with acute onset of pain, a palpable defect in the tendon, and difficulty in ambulation. Diagnosis typically involves a thorough clinical examination and imaging studies, such as MRI or ultrasound, to confirm the rupture and assess the extent of the injury. Treatment options may include conservative management with rest and physical therapy or surgical intervention to repair the torn tendon, depending on the severity of the rupture and the patient's overall health status. Accurate coding is essential for appropriate reimbursement and to reflect the complexity of the condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between spontaneous and traumatic ruptures
  • Identifying the specific tendon involved
  • Documenting the patient's history and underlying conditions
  • 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 studies to support the diagnosis
  • Inconsistent treatment documentation

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed notes on the mechanism of injury, physical examination findings, and imaging results.

Common Clinical Scenarios

Patients presenting with acute thigh pain, swelling, and functional limitations.

Billing Considerations

Ensure clear documentation of the tendon involved and the treatment plan, especially if surgical repair is performed.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessment of functional limitations and rehabilitation goals.

Common Clinical Scenarios

Patients recovering from tendon repair or those undergoing conservative management.

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use M66.852 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the spontaneous rupture and the specific tendon involved
  • Include any relevant co
  • morbidities that may affect treatment and recovery

Exclusion Criteria

Do NOT use M66.852 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27301CPT Code

Repair of ruptured tendon, thigh

Clinical Scenario

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

Documentation Requirements

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

Specialty Considerations

Orthopedic surgeons must document the specific tendon repaired and any complications.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 allows for more specific coding of tendon ruptures, improving the accuracy of patient records and facilitating better reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 allows for more specific coding of tendon ruptures, improving the accuracy of patient records and facilitating better reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 degenerative changes, while traumatic rupture is the result of a specific injury or accident.