ICD Code M65.869

ICD code M65.869 is used to identify a medical condition characterized by inflammation of the synovial membrane and tendon sheath in the lower leg, but without specifying which part of the lower leg is affected. Synovitis refers to the inflammation of the synovial membrane, which lines joints and tendons, while tenosynovitis involves inflammation of the tendon sheath. This code is typically used when the exact location within the lower leg is not detailed in the medical documentation, allowing healthcare providers to categorize and manage the condition effectively for billing and treatment purposes.

When to use the ICD code M65869 for Other synovitis and tenosynovitis, unspecified lower leg, consider the following diagnostic criteria and symptoms:

1. Presence of Synovitis
- Swelling in the lower leg joint areas, indicating inflammation of the synovial membrane.

2. Presence of Tenosynovitis
- Pain and swelling along the tendons in the lower leg, particularly around the ankle or foot.

3. Localized Pain
- Discomfort or pain in the lower leg that may worsen with movement or pressure.

4. Limited Range of Motion
- Difficulty in moving the affected joint or tendon due to pain or swelling.

5. Tenderness on Palpation
- Sensitivity or pain when the affected area is touched or pressed.

6. Warmth and Redness
- Increased warmth and possible redness over the affected area, indicating inflammation.

7. History of Injury or Overuse
- Recent history of trauma, repetitive strain, or overuse of the lower leg that may contribute to the condition.

8. Exclusion of Other Conditions
- Ruling out other potential causes of lower leg pain and swelling, such as fractures, infections, or systemic diseases.

9. Duration of Symptoms
- Symptoms persisting for a significant period, typically more than a few days, without improvement.

10. Diagnostic Imaging Findings
- Imaging studies (e.g., MRI, ultrasound) showing signs of synovitis or tenosynovitis in the lower leg.

These criteria should be evaluated to determine the appropriateness of using the specified ICD code for documentation and billing purposes.

For the ICD code M65869, which pertains to other synovitis and tenosynovitis of the unspecified lower leg, 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., knee, hip, shoulder joint); without ultrasound guidance.

2. 20611 - Arthrocentesis, aspiration, and/or injection into a major joint or bursa (e.g., knee, hip, shoulder joint); with ultrasound guidance, with permanent recording and reporting.

3. 27370 - Injection of contrast for knee arthrography.

4. 27600 - Tenotomy, percutaneous, Achilles tendon (separate procedure); local anesthesia.

5. 27605 - Tenotomy, percutaneous, Achilles tendon (separate procedure); general anesthesia.

6. 27650 - Repair, primary, open or percutaneous, ruptured Achilles tendon.

7. 27652 - Repair, primary, open or percutaneous, ruptured Achilles tendon; with graft (includes obtaining graft).

8. 29888 - Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction.

These CPT codes are examples of procedures that might be performed to address conditions associated with synovitis and tenosynovitis in the lower leg. It is important for healthcare providers to select the most appropriate CPT code based on the specific procedure performed and the clinical scenario. Always verify with the latest coding guidelines and payer policies to ensure accurate coding and billing.

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