ICD Code M65.812

ICD code M65.812 is used to identify a medical condition characterized by inflammation of the synovium and tendon sheath in the left shoulder. Synovitis refers to the inflammation of the synovial membrane, which lines joints and tendons, while tenosynovitis involves inflammation of the tendon sheath. This condition can cause pain, swelling, and reduced mobility in the affected shoulder, impacting a patient's ability to perform daily activities. Proper diagnosis and coding of this condition are crucial for effective treatment planning and accurate billing in the healthcare revenue cycle.

When to use the ICD code M65812 for Other synovitis and tenosynovitis, left shoulder:

1. Presence of Synovitis
- Swelling and inflammation of the synovial membrane in the left shoulder joint.

2. Symptoms of Tenosynovitis
- Pain and tenderness around the tendons in the left shoulder area.
- Difficulty in moving the shoulder due to pain or stiffness.

3. Duration of Symptoms
- Symptoms persisting for a significant period, typically more than a few weeks.

4. Exclusion of Other Conditions
- Rule out other potential causes of shoulder pain, such as fractures, rotator cuff injuries, or arthritis.

5. Diagnostic Imaging Findings
- MRI or ultrasound results indicating inflammation of the synovial lining or tendons in the left shoulder.

6. Response to Treatment
- Lack of improvement with conservative treatments such as rest, ice, or anti-inflammatory medications.

7. Clinical Examination Findings
- Positive findings during physical examination, including tenderness, swelling, and limited range of motion in the left shoulder.

8. Patient History
- Relevant history of repetitive shoulder use or prior injuries that may contribute to the condition.

9. Associated Symptoms
- Possible presence of systemic symptoms such as fever or malaise, indicating a more widespread inflammatory process.

10. Referral to Specialist
- Consideration for referral to an orthopedic specialist for further evaluation if symptoms are severe or persistent.

For the ICD code M65.812, which pertains to "Other synovitis and tenosynovitis, left shoulder," the relevant CPT codes that may be applicable for treatment include:

1. 20610 - Arthrocentesis, aspiration, and/or injection into a major joint or bursa (e.g., shoulder, hip, knee joint, subacromial bursa); without ultrasound guidance.

2. 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.

3. 29821 - Arthroscopy, shoulder, surgical; synovectomy, partial.

4. 29822 - Arthroscopy, shoulder, surgical; debridement, limited.

5. 29823 - Arthroscopy, shoulder, surgical; debridement, extensive.

6. 20550 - Injection(s); single tendon sheath, or ligament, aponeurosis (e.g., plantar "fascia").

These CPT codes are commonly used for procedures that may be performed to treat conditions associated with synovitis and tenosynovitis of the left shoulder. It's important for healthcare providers to select the appropriate CPT code based on the specific procedure performed and the clinical scenario. Always ensure that the chosen CPT code accurately reflects the services provided and is supported by the documentation in the patient's medical record.

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