ICD Code M66.111

ICD code M66.111 is used to classify and document a medical diagnosis of a rupture of the synovium in the right shoulder. The synovium is a specialized connective tissue that lines the inner surface of capsules of synovial joints and tendon sheath. A rupture in this area can lead to pain, swelling, and impaired movement of the shoulder joint. This code is part of the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM), which is used by healthcare providers to ensure accurate diagnosis and facilitate effective communication with insurance companies for billing and reimbursement purposes.

When to use the ICD code for a rupture of the synovium in the right shoulder:

1. Clinical Diagnosis: Confirmed diagnosis of synovial rupture through clinical evaluation.

2. Symptoms Present:

- Localized pain in the right shoulder.

- Swelling or inflammation around the shoulder joint.

- Limited range of motion in the right shoulder.

- Tenderness upon palpation of the shoulder area.

- Possible crepitus or a popping sensation during movement.

3. Imaging Findings: Evidence of synovial rupture observed in imaging studies (e.g., MRI, ultrasound).

4. History of Trauma: Recent history of injury or trauma to the right shoulder that may have contributed to the rupture.

5. Chronic Conditions: Presence of underlying chronic conditions that may predispose to synovial rupture (e.g., rheumatoid arthritis, previous joint surgeries).

6. Exclusion of Other Conditions: Differential diagnosis ruling out other potential causes of shoulder pain and swelling, such as fractures or tendon injuries.

7. Treatment Plan: Documentation of a treatment plan that addresses the rupture, including potential surgical intervention or conservative management strategies.

For the ICD code M66.111, which pertains to the rupture of synovium in the right shoulder, the relevant CPT codes that may be applicable for treatment include:

1. CPT 29806 - Arthroscopy, shoulder, surgical; capsulorrhaphy.

2. CPT 29807 - Arthroscopy, shoulder, surgical; repair of a superior labral anterior posterior (SLAP) lesion.

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

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

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

These CPT codes are commonly used for procedures that address issues related to the synovium and other structures within the shoulder joint. It's important for healthcare providers to select the appropriate CPT code based on the specific procedure performed and the clinical scenario.

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