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ICD-10 Guide
ICD-10 CodesM67.229

M67.229

Billable

Synovial hypertrophy, not elsewhere classified, unspecified upper arm

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

Code Description

ICD-10 M67.229 is a billable code used to indicate a diagnosis of synovial hypertrophy, not elsewhere classified, unspecified upper arm.

Key Diagnostic Point:

Synovial hypertrophy refers to the abnormal enlargement of the synovial membrane, which lines the joints and tendon sheaths. This condition can occur in various joints, including the upper arm, and is often associated with inflammatory processes. In the upper arm, synovial hypertrophy may result from conditions such as rheumatoid arthritis, osteoarthritis, or repetitive strain injuries. Patients may present with symptoms such as joint swelling, pain, and limited range of motion. The diagnosis is typically made through clinical evaluation and imaging studies, such as ultrasound or MRI, which can visualize the thickened synovial tissue. Treatment options may include corticosteroid injections, physical therapy, and in some cases, surgical intervention to remove the hypertrophied tissue. 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

  • Variability in clinical presentation and underlying causes
  • Need for precise documentation of symptoms and imaging findings
  • Differentiation from other synovial disorders
  • Potential for co-existing conditions affecting coding

Audit Risk Factors

  • Insufficient documentation of clinical findings
  • Lack of imaging studies to support diagnosis
  • Inconsistent coding of related conditions
  • Failure to document treatment plans and responses

Specialty Focus

Medical Specialties

Rheumatology

Documentation Requirements

Detailed history of joint symptoms, physical examination findings, and imaging results.

Common Clinical Scenarios

Patients with inflammatory arthritis presenting with joint swelling and pain.

Billing Considerations

Ensure documentation reflects the specific joint involved and any underlying inflammatory conditions.

Orthopedic Surgery

Documentation Requirements

Surgical notes detailing the procedure performed, indications for surgery, and post-operative care.

Common Clinical Scenarios

Patients requiring surgical intervention for persistent synovial hypertrophy causing functional impairment.

Billing Considerations

Document the rationale for surgery and any pre-operative imaging findings.

Coding Guidelines

Inclusion Criteria

Use M67.229 When
  • Follow official ICD
  • 10 guidelines for coding synovial disorders
  • Ensure that the code is used when the condition is not classified elsewhere and that the documentation supports the diagnosis

Exclusion Criteria

Do NOT use M67.229 When
No specific exclusions found.

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 aspiration of the swollen joint to relieve pressure.

Documentation Requirements

Document the indication for the procedure, the joint involved, and the amount of fluid removed.

Specialty Considerations

Rheumatologists should ensure that the procedure is linked to the diagnosis of synovial hypertrophy.

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 is the primary cause of synovial hypertrophy?

Synovial hypertrophy is primarily caused by inflammatory conditions, such as rheumatoid arthritis or mechanical stress from repetitive activities.