ICD Code M65.20

ICD code M6520 is used to identify a medical condition known as calcific tendinitis, where calcium deposits form in the tendons, leading to pain and inflammation. The term "unspecified site" indicates that the specific location of the calcific tendinitis within the body has not been detailed in the medical documentation. This code is utilized in healthcare settings to facilitate accurate billing and ensure that healthcare providers can track and manage the treatment of this condition effectively.

When to use the ICD code M6520 (Calcific tendinitis, unspecified site):

1. Presence of Calcific Deposits: Evidence of calcification in the tendons, typically identified through imaging studies such as X-rays or ultrasounds.

2. Localized Pain: Patient reports localized pain in the affected area, which may worsen with movement or pressure.

3. Reduced Range of Motion: Observed limitation in the range of motion of the joint associated with the affected tendon.

4. Swelling or Inflammation: Signs of swelling or inflammation around the tendon, which may be accompanied by tenderness upon palpation.

5. History of Overuse or Injury: Patient has a history of repetitive motion or overuse of the affected tendon, or a recent injury that may have contributed to the condition.

6. Age Factor: Typically occurs in adults, often in middle-aged individuals, which may be relevant in assessing the likelihood of calcific tendinitis.

7. Exclusion of Other Conditions: Other potential causes of tendon pain and inflammation have been ruled out, ensuring that the diagnosis is specific to calcific tendinitis.

8. Chronic Symptoms: Symptoms have persisted for a duration that suggests a chronic condition, rather than an acute injury.

9. Response to Conservative Treatment: Lack of improvement with conservative treatment measures, such as rest, ice, or physical therapy, may indicate the need for further diagnostic coding.

These criteria help healthcare providers determine the appropriate use of the ICD code for accurate documentation and billing purposes.

For the ICD code M6520, which pertains to calcific tendinitis of an unspecified site, the relevant CPT codes that may be applicable for treatment include:

1. 20550 - Injection(s); single tendon sheath, or ligament, aponeurosis (e.g., plantar "fascia").

2. 20610 - Arthrocentesis, aspiration, and/or injection into a major joint or bursa (e.g., shoulder, hip, knee joint, subacromial bursa); without ultrasound guidance.

3. 20611 - Arthrocentesis, aspiration, and/or injection into a major joint or bursa (e.g., shoulder, hip, knee joint, subacromial bursa); with ultrasound guidance, with permanent recording and reporting.

4. 23929 - Unlisted procedure, shoulder.

5. 27329 - Removal of foreign body, knee area; deep.

These CPT codes are commonly used in procedures that may be involved in the treatment of calcific tendinitis, depending on the specific clinical scenario and the healthcare provider's treatment plan. Always ensure that the chosen CPT code accurately reflects the procedure performed and is supported by the documentation in the patient's medical record.

Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately reading your contracts and detecting underpayments for CPT codes associated with ICD codes, such as M6520. Don't let potential revenue slip through the cracks. Schedule a demo today to see how RevFind can optimize your financial outcomes.