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ICD-10 Guide
ICD-10 CodesM66.872

M66.872

Billable

Spontaneous rupture of other tendons, left ankle and foot

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

Code Description

ICD-10 M66.872 is a billable code used to indicate a diagnosis of spontaneous rupture of other tendons, left ankle and foot.

Key Diagnostic Point:

Spontaneous rupture of tendons in the left ankle and foot can occur due to various factors, including underlying degenerative conditions, inflammatory processes, 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 ankle and foot, such as the peroneal tendons, Achilles tendon, and others, can be affected. Patients may present with acute pain, inability to bear weight, and visible deformity in the affected area. Diagnosis typically involves a thorough clinical examination, imaging studies such as MRI or ultrasound, and assessment of functional limitations. Treatment may vary from conservative management, including rest and physical therapy, to surgical intervention for tendon repair or reconstruction, depending on the severity of the rupture and the patient's overall health status. Accurate coding is essential for proper reimbursement and tracking of healthcare 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 specific tendon involved
  • Differentiation from other tendon injuries or conditions
  • Potential for concurrent injuries in the ankle and foot region

Audit Risk Factors

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

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative notes, imaging results, and pre- and post-operative assessments.

Common Clinical Scenarios

Patients presenting with acute ankle pain following a fall or sports injury.

Billing Considerations

Ensure documentation reflects the specific tendon involved and any associated injuries.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive evaluations, treatment plans, and progress notes.

Common Clinical Scenarios

Rehabilitation following surgical repair of tendon ruptures.

Billing Considerations

Document functional limitations and rehabilitation goals clearly.

Coding Guidelines

Inclusion Criteria

Use M66.872 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the condition, laterality, and any associated injuries
  • Include relevant clinical information to support the diagnosis

Exclusion Criteria

Do NOT use M66.872 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27658CPT Code

Repair of ruptured tendon

Clinical Scenario

Used when surgical repair is performed for spontaneous tendon rupture.

Documentation Requirements

Operative report detailing the procedure and findings.

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 has allowed for more specific coding of tendon ruptures, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of tendon ruptures, improving the accuracy of data collection and 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 conditions, while traumatic rupture is a direct result of an injury.