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ICD-10 Guide
ICD-10 CodesM67.212

M67.212

Billable

Synovial hypertrophy, not elsewhere classified, left shoulder

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

Code Description

ICD-10 M67.212 is a billable code used to indicate a diagnosis of synovial hypertrophy, not elsewhere classified, left shoulder.

Key Diagnostic Point:

Synovial hypertrophy refers to the abnormal enlargement of the synovial membrane, which lines the joints and produces synovial fluid. This condition can occur due to various underlying causes, including inflammatory arthritis, trauma, or chronic mechanical stress. In the left shoulder, synovial hypertrophy may lead to pain, swelling, and reduced range of motion. Patients often present with symptoms such as joint stiffness, tenderness, and discomfort during movement. The diagnosis typically involves a thorough clinical evaluation, imaging studies like MRI or ultrasound, and possibly synovial fluid analysis to rule out infections or other pathologies. Treatment options may include corticosteroid injections, physical therapy, or surgical interventions such as synovectomy if conservative measures fail. Understanding the underlying cause of synovial hypertrophy is crucial for effective management and to prevent further joint damage.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between various types of synovial disorders
  • Need for precise documentation of symptoms and imaging findings
  • Potential overlap with other shoulder conditions like bursitis or tendinitis
  • Variability in treatment approaches based on underlying causes

Audit Risk Factors

  • Inadequate documentation of the patient's symptoms and history
  • Failure to specify the laterality of the condition
  • Misclassification of the condition as a more specific diagnosis
  • Lack of imaging or procedural documentation to support the diagnosis

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed notes on physical examination findings, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with shoulder pain, limited range of motion, or previous shoulder injuries.

Billing Considerations

Ensure that all relevant imaging studies are documented to support the diagnosis of synovial hypertrophy.

Rheumatology

Documentation Requirements

Comprehensive assessment of joint symptoms, history of autoimmune diseases, and laboratory results.

Common Clinical Scenarios

Patients with inflammatory arthritis presenting with joint swelling and pain.

Billing Considerations

Document any systemic symptoms that may indicate an underlying rheumatologic condition.

Coding Guidelines

Inclusion Criteria

Use M67.212 When
  • According to ICD
  • 10 guidelines, M67
  • 212 should be used when synovial hypertrophy is confirmed and not classified elsewhere
  • Coders must ensure that the diagnosis is supported by clinical documentation and imaging studies

Exclusion Criteria

Do NOT use M67.212 When
  • Exclusion criteria include conditions that are more specifically classified under other codes

Related ICD-10 Codes

Related CPT Codes

20610CPT Code

Arthrocentesis, aspiration of a major joint or bursa

Clinical Scenario

Used when synovial fluid analysis is needed to confirm diagnosis.

Documentation Requirements

Document the reason for aspiration, findings, and any fluid analysis results.

Specialty Considerations

Orthopedic specialists should ensure that the procedure is justified based on clinical findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like synovial hypertrophy, improving the accuracy of diagnoses and treatment plans. This specificity helps in better tracking of patient outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like synovial hypertrophy, improving the accuracy of diagnoses and treatment plans. This specificity helps in better tracking of patient outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like synovial hypertrophy, improving the accuracy of diagnoses and treatment plans. This specificity helps in better tracking of patient outcomes and resource allocation.

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 treatments for synovial hypertrophy?

Common treatments include corticosteroid injections, physical therapy, and in some cases, surgical intervention such as synovectomy.