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ICD-10 Guide
ICD-10 CodesM67.221

M67.221

Billable

Synovial hypertrophy, not elsewhere classified, right upper arm

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

Code Description

ICD-10 M67.221 is a billable code used to indicate a diagnosis of synovial hypertrophy, not elsewhere classified, right upper arm.

Key Diagnostic Point:

Synovial hypertrophy refers to the abnormal enlargement of the synovial membrane, which lines the joints and tendon sheaths. In the context of the right upper arm, this condition may arise due to various underlying factors, including inflammatory processes, repetitive strain injuries, or degenerative changes. Patients may present with symptoms such as joint swelling, pain, and limited range of motion. Synovial hypertrophy can be associated with conditions like tenosynovitis, where inflammation occurs in the synovial sheath surrounding a tendon, potentially leading to tendon ruptures if left untreated. Surgical interventions may be necessary to address severe cases, including synovectomy or tendon repair, depending on the extent of damage and the patient's overall health. Accurate diagnosis often requires imaging studies and a thorough clinical evaluation to differentiate it from other joint disorders. Treatment typically involves a combination of conservative management, such as physical therapy and anti-inflammatory medications, and surgical options for more severe cases.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between various types of synovial disorders.
  • Understanding the relationship between synovial hypertrophy and other conditions like tenosynovitis.
  • Identifying the appropriate surgical procedures related to the condition.
  • Navigating documentation requirements for multiple specialties involved in treatment.

Audit Risk Factors

  • Inadequate documentation of the specific location and extent of hypertrophy.
  • Failure to document associated conditions like tenosynovitis or tendon ruptures.
  • Lack of clarity in surgical reports regarding procedures performed.
  • Inconsistent coding practices across different specialties.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed surgical notes, imaging results, and post-operative care plans.

Common Clinical Scenarios

Patients presenting with joint pain and swelling, requiring surgical intervention.

Billing Considerations

Ensure accurate coding of any associated procedures, such as tendon repair or synovectomy.

Rheumatology

Documentation Requirements

Comprehensive patient history, physical examination findings, and laboratory results.

Common Clinical Scenarios

Patients with inflammatory arthritis presenting with synovial hypertrophy.

Billing Considerations

Document any systemic symptoms or comorbidities that may affect treatment.

Coding Guidelines

Inclusion Criteria

Use M67.221 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used only when synovial hypertrophy is confirmed and not attributable to other specified conditions
  • Document the specific location and any associated diagnoses

Exclusion Criteria

Do NOT use M67.221 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

29875CPT Code

Arthroscopy, shoulder, surgical

Clinical Scenario

Used when performing arthroscopy to address synovial hypertrophy.

Documentation Requirements

Detailed operative report outlining findings and procedures performed.

Specialty Considerations

Orthopedic surgeons should ensure clear documentation of the diagnosis and surgical indications.

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 patient records and facilitating better treatment planning.

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 patient records and facilitating better treatment planning.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like synovial hypertrophy, improving the accuracy of patient records and facilitating better treatment planning.

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 synovial hypertrophy?

Common causes include inflammatory arthritis, repetitive strain injuries, and degenerative joint diseases. It can also occur in response to trauma or infection.