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ICD-10 Guide
ICD-10 CodesM67.25

M67.25

Billable

Synovial hypertrophy, not elsewhere classified, thigh

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

Code Description

ICD-10 M67.25 is a billable code used to indicate a diagnosis of synovial hypertrophy, not elsewhere classified, thigh.

Key Diagnostic Point:

Synovial hypertrophy refers to the abnormal enlargement of the synovial membrane, which lines the joints and tendon sheaths. In the thigh, this condition can be associated with various underlying pathologies, including inflammatory arthritis, chronic tenosynovitis, or mechanical stress. The hypertrophy may lead to joint effusion, pain, and restricted mobility. Patients may present with symptoms such as swelling, tenderness, and discomfort during movement. The condition is often diagnosed through clinical examination and imaging studies, such as ultrasound or MRI, which can reveal the extent of synovial thickening and associated joint changes. Treatment typically involves addressing the underlying cause, which may include corticosteroid injections, physical therapy, or surgical intervention if conservative measures fail. Surgical options may involve synovectomy or repair of associated tendon injuries, particularly if there is concurrent tenosynovitis or tendon rupture. Accurate coding is essential for proper reimbursement and to reflect the complexity of the patient's condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between various types of synovial disorders
  • Need for precise documentation of underlying causes
  • Potential for concurrent conditions affecting coding
  • Variability in treatment approaches and their documentation

Audit Risk Factors

  • Inadequate documentation of the underlying cause of synovial hypertrophy
  • Failure to document associated symptoms or functional limitations
  • Lack of imaging studies to support the diagnosis
  • Incorrect linkage of the diagnosis to treatment procedures

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed clinical notes including history, physical examination findings, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with knee pain and swelling, suspected tendon injuries, or chronic joint conditions.

Billing Considerations

Ensure that all relevant imaging studies are documented and linked to the diagnosis.

Rheumatology

Documentation Requirements

Comprehensive assessment of joint symptoms, laboratory tests, and response to treatment.

Common Clinical Scenarios

Patients with inflammatory arthritis presenting with joint swelling and pain.

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use M67.25 When
  • According to ICD
  • 10 guidelines, M67
  • 25 should be used when synovial hypertrophy is documented without a more specific classification
  • Coders should ensure that the documentation supports the diagnosis and that any associated conditions are also coded appropriately

Exclusion Criteria

Do NOT use M67.25 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

20610CPT Code

Arthrocentesis, aspiration of a major joint or bursa

Clinical Scenario

Used when a patient with synovial hypertrophy presents with joint effusion.

Documentation Requirements

Document the reason for aspiration and findings during the procedure.

Specialty Considerations

Orthopedic specialists should ensure that the procedure is 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 patient records and reimbursement processes. This specificity helps in better tracking of treatment 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 patient records and reimbursement processes. This specificity helps in better tracking of treatment outcomes and resource allocation.

Reimbursement & Billing Impact

reimbursement processes. This specificity helps in better tracking of treatment 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 is the primary cause of synovial hypertrophy?

Synovial hypertrophy is primarily caused by inflammation, which can result from various conditions such as arthritis, repetitive stress, or injury.