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ICD-10 Guide
ICD-10 CodesM67.219

M67.219

Billable

Synovial hypertrophy, not elsewhere classified, unspecified shoulder

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

Code Description

ICD-10 M67.219 is a billable code used to indicate a diagnosis of synovial hypertrophy, not elsewhere classified, unspecified 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 in various joints, including the shoulder, and is often associated with inflammatory processes. In the shoulder, synovial hypertrophy may result from chronic conditions such as rheumatoid arthritis, osteoarthritis, or repetitive strain injuries. Patients may present with symptoms such as joint pain, swelling, stiffness, and decreased range of motion. The diagnosis is typically made through clinical evaluation, imaging studies, and sometimes arthroscopy. Treatment options may include physical therapy, corticosteroid injections, and in severe cases, surgical intervention to remove excess synovial tissue or repair damaged structures. Understanding the underlying causes and associated conditions is crucial for effective management and coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and underlying causes
  • Need for comprehensive documentation to support diagnosis
  • Potential overlap with other synovial disorders
  • Differentiation from other shoulder conditions such as tenosynovitis

Audit Risk Factors

  • Insufficient documentation of symptoms and clinical findings
  • Lack of imaging studies to support diagnosis
  • Inconsistent use of terminology in medical records
  • Failure to document treatment plans and responses

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 and swelling, often after trauma or repetitive use.

Billing Considerations

Ensure clarity in distinguishing between synovial hypertrophy and other shoulder pathologies.

Rheumatology

Documentation Requirements

Comprehensive history of autoimmune conditions, lab results, and response to treatments.

Common Clinical Scenarios

Patients with inflammatory arthritis presenting with joint swelling and pain.

Billing Considerations

Documenting the systemic nature of conditions that may contribute to synovial hypertrophy.

Coding Guidelines

Inclusion Criteria

Use M67.219 When
  • Follow official ICD
  • CM guidelines for coding synovial disorders
  • Ensure that the diagnosis is supported by clinical documentation and imaging studies

Exclusion Criteria

Do NOT use M67.219 When
  • Exclude conditions that are specifically classified elsewhere

Related ICD-10 Codes

Related CPT Codes

20610CPT Code

Arthrocentesis, aspiration and/or injection into a major joint or bursa

Clinical Scenario

Used when performing an injection for treatment of synovial hypertrophy.

Documentation Requirements

Document the indication for the procedure, the joint involved, and the response to treatment.

Specialty Considerations

Orthopedic specialists should ensure that the procedure is clearly linked to the diagnosis.

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 data collection and reimbursement processes.

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 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 synovial hypertrophy?

Synovial hypertrophy is the thickening of the synovial membrane, often due to inflammation or chronic irritation, leading to joint swelling and pain.

How is synovial hypertrophy diagnosed?

Diagnosis typically involves a combination of clinical evaluation, imaging studies such as MRI or ultrasound, and sometimes arthroscopy to assess the joint.

What are the treatment options for synovial hypertrophy?

Treatment may include physical therapy, corticosteroid injections, and surgical options if conservative measures fail.