ICD Code M65.28

ICD code M6528 is used to identify a medical condition known as calcific tendinitis occurring in a site other than those specifically categorized in other ICD codes. Calcific tendinitis is characterized by the accumulation of calcium deposits in the tendons, which can lead to pain, inflammation, and reduced mobility in the affected area. This particular code is utilized when the calcific tendinitis is present in a location not otherwise specified, allowing healthcare providers to accurately document and track the condition for treatment and billing purposes.

When considering the use of the ICD code M6528 for calcific tendinitis at other sites, the following diagnostic criteria and symptoms should be evaluated:

1. Presence of Pain: Patients typically report localized pain in the affected area, which may worsen with movement or pressure.

2. Swelling and Inflammation: Observe for signs of swelling or inflammation around the tendon, which may indicate an acute inflammatory response.

3. Limited Range of Motion: Assess for any restrictions in the range of motion in the affected joint or limb, often due to pain or mechanical blockage.

4. Tenderness on Palpation: The affected area may be tender to touch, indicating irritation or inflammation of the tendon.

5. Imaging Findings: Confirmatory imaging studies (such as X-rays or ultrasound) should reveal calcific deposits within the tendon or surrounding tissues.

6. Duration of Symptoms: Evaluate the duration of symptoms, as chronic cases may present differently than acute cases.

7. Exclusion of Other Conditions: Rule out other potential causes of similar symptoms, such as tendon tears, bursitis, or other inflammatory conditions.

8. Response to Conservative Treatment: Consider the patient's response to conservative treatment measures, such as rest, ice, or physical therapy, which may help differentiate calcific tendinitis from other conditions.

By adhering to these diagnostic criteria and symptoms, healthcare providers can accurately determine the appropriateness of using the ICD code M6528.

For the ICD code M65.28, which pertains to calcific tendinitis of other sites, 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. 24357 - Tenotomy, shoulder area; percutaneous, with manipulation, including anesthetic injection(s).

6. 24359 - Tenotomy, shoulder area; open, with or without tendon lengthening, each tendon.

7. 29826 - Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with or without coracoacromial release.

8. 29827 - Arthroscopy, shoulder, surgical; with rotator cuff repair.

These CPT codes are typically used for procedures that address conditions related to calcific tendinitis, depending on the specific treatment plan and site of the tendinitis. Always ensure that the selected CPT codes align with the specific services provided and are supported by the clinical documentation.

Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately reading your contracts and identifying underpayments for CPT codes associated with ICD code M6528. Schedule a demo today to see how RevFind can help you capture every dollar you're owed.