ICD Code M65.90

ICD code M6590 is used to identify a medical condition characterized by inflammation of the synovial membrane (synovitis) and the sheath surrounding a tendon (tenosynovitis) at an unspecified location in the body. This code is typically used when the specific site of the inflammation is not detailed in the medical documentation. Synovitis and tenosynovitis can cause pain, swelling, and reduced movement in the affected area, and this code helps healthcare providers and billing professionals categorize and manage the condition for treatment and reimbursement purposes.

When considering the use of the ICD code for unspecified synovitis and tenosynovitis, unspecified site, healthcare providers should evaluate the following diagnostic criteria and symptoms:

1. Joint Swelling: Presence of noticeable swelling in one or more joints, which may be due to inflammation of the synovial membrane or tendon sheath.

2. Pain and Tenderness: The patient reports pain and tenderness around the affected joint or tendon, which may worsen with movement or pressure.

3. Stiffness: The patient experiences stiffness in the joint, particularly after periods of inactivity or in the morning, which may improve with movement.

4. Reduced Range of Motion: There is a noticeable limitation in the range of motion of the affected joint, impacting the patient's ability to perform daily activities.

5. Warmth and Redness: The affected area may exhibit warmth and redness, indicating an inflammatory process.

6. Absence of Specific Site Identification: The specific site of the synovitis or tenosynovitis cannot be precisely identified, necessitating the use of an unspecified code.

7. Exclusion of Other Conditions: Other potential causes of joint pain and swelling, such as arthritis, gout, or infection, have been ruled out through clinical evaluation and diagnostic testing.

8. Chronic or Acute Presentation: The condition may present as either acute or chronic, with varying degrees of severity and duration.

9. Patient History and Physical Examination: A thorough patient history and physical examination support the diagnosis of synovitis or tenosynovitis without a specific site.

By adhering to these criteria, healthcare providers can ensure accurate coding and documentation, facilitating effective communication and management within the healthcare revenue cycle.

For the ICD code M65.90, which refers to unspecified synovitis and tenosynovitis at an unspecified site, 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. 20550 - Injection(s); single tendon sheath, or ligament, aponeurosis (e.g., plantar "fascia").

4. 20551 - Injection(s); single tendon origin/insertion.

5. 76942 - Ultrasonic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), imaging supervision and interpretation.

These CPT codes are commonly used for procedures that might be performed to address conditions related to synovitis and tenosynovitis. It's important for healthcare providers to select the appropriate CPT code based on the specific procedure performed and the clinical scenario.

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 code M6590. Schedule a demo today to see how RevFind can ensure you're receiving the full reimbursement you deserve.