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ICD-10 Guide
ICD-10 CodesM67.26

M67.26

Billable

Synovial hypertrophy, not elsewhere classified, lower leg

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

Code Description

ICD-10 M67.26 is a billable code used to indicate a diagnosis of synovial hypertrophy, not elsewhere classified, lower leg.

Key Diagnostic Point:

Synovial hypertrophy refers to the abnormal enlargement of the synovial membrane, which lines the joints and tendon sheaths. In the lower leg, this condition can manifest due to various underlying causes, including inflammatory diseases, repetitive trauma, or degenerative changes. Patients may present with symptoms such as swelling, pain, and limited range of motion in the affected area. This condition is often associated with tenosynovitis, where inflammation occurs in the synovial sheath surrounding a tendon, leading to pain and dysfunction. Synovial hypertrophy can also predispose individuals to tendon ruptures, particularly in cases where the tendon is compromised by inflammation or mechanical stress. Surgical interventions, such as synovectomy or tendon repair, may be necessary in severe cases to alleviate symptoms and restore function. Accurate diagnosis typically involves imaging studies, such as ultrasound or MRI, to assess the extent of synovial involvement and rule out other pathologies.

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

  • Inadequate documentation of symptoms and clinical findings
  • Failure to specify the location of synovial hypertrophy
  • Misclassification with other synovial disorders
  • Lack of imaging studies to support 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 knee or ankle pain, swelling, and limited mobility due to synovial hypertrophy.

Billing Considerations

Ensure to document any surgical interventions or referrals to physical therapy.

Rheumatology

Documentation Requirements

Comprehensive assessment of inflammatory markers, patient history, and response to treatment.

Common Clinical Scenarios

Patients with autoimmune conditions presenting with joint swelling and pain.

Billing Considerations

Document any systemic symptoms and laboratory findings to support the diagnosis.

Coding Guidelines

Inclusion Criteria

Use M67.26 When
  • Follow official coding guidelines for synovial disorders, ensuring to document the specific location and nature of the hypertrophy
  • Include any relevant imaging studies and treatment plans

Exclusion Criteria

Do NOT use M67.26 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

29875CPT Code

Arthroscopy, knee, diagnostic, with or without synovial biopsy

Clinical Scenario

Used when synovial hypertrophy is suspected and requires confirmation through arthroscopy.

Documentation Requirements

Document indications for the procedure, findings, and any interventions performed.

Specialty Considerations

Orthopedic surgeons should ensure thorough documentation of the surgical findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of synovial disorders, improving the accuracy of diagnoses and treatment tracking. M67.26 provides a distinct code for synovial hypertrophy, which was less clearly defined in ICD-9.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of synovial disorders, improving the accuracy of diagnoses and treatment tracking. M67.26 provides a distinct code for synovial hypertrophy, which was less clearly defined in ICD-9.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of synovial disorders, improving the accuracy of diagnoses and treatment tracking. M67.26 provides a distinct code for synovial hypertrophy, which was less clearly defined in ICD-9.

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 conditions such as rheumatoid arthritis, repetitive trauma, and degenerative joint diseases. It can also occur following tendon injuries or surgeries.