ICD Code M66.211

ICD code M66.211 is used to classify and document a medical diagnosis of a spontaneous rupture of extensor tendons in the right shoulder. This condition involves the sudden tearing or breaking of the tendons responsible for extending or straightening the arm at the shoulder joint, without any apparent external trauma or injury. This code is crucial for healthcare providers to accurately record the condition for treatment planning, billing, and insurance purposes, ensuring that the patient's medical records reflect the specific nature of their shoulder injury.

When to use the ICD code for spontaneous rupture of extensor tendons in the right shoulder:

1. Clinical Diagnosis: A healthcare provider has made a clinical diagnosis of spontaneous rupture of extensor tendons in the right shoulder based on patient evaluation.

2. Patient Symptoms:

- Sudden onset of pain in the right shoulder.

- Limited range of motion in the shoulder joint.

- Swelling or inflammation around the shoulder area.

- Difficulty in extending the arm or performing overhead activities.

- Tenderness upon palpation of the shoulder and surrounding structures.

3. Imaging Findings: Diagnostic imaging (e.g., MRI or ultrasound) confirms the presence of a rupture in the extensor tendons of the right shoulder.

4. Exclusion of Other Conditions: Other potential causes of shoulder pain and dysfunction (e.g., fractures, tendonitis, or impingement syndrome) have been ruled out through clinical assessment and imaging.

5. Patient History: The patient may have a history of trauma or repetitive strain to the shoulder, contributing to the diagnosis.

6. Treatment Plan: A treatment plan has been established that may include surgical intervention, physical therapy, or other management strategies specific to the condition.

7. Documentation: All findings, symptoms, and treatment plans are thoroughly documented in the patient's medical record to support the use of the ICD code.

For the ICD code M66.211, which pertains to the spontaneous rupture of extensor tendons in the right shoulder, the relevant CPT codes that may be applicable for treatment include:

1. 23410 - Repair of ruptured musculotendinous cuff (e.g., rotator cuff) open; acute.

2. 23412 - Repair of ruptured musculotendinous cuff (e.g., rotator cuff) open; chronic.

3. 23420 - Reconstruction of complete shoulder (rotator) cuff avulsion, chronic (includes acromioplasty).

4. 24341 - Repair, tendon or muscle, upper arm or elbow, each tendon or muscle, primary or secondary (excludes rotator cuff).

5. 29827 - Arthroscopy, shoulder, surgical; with rotator cuff repair.

These CPT codes are typically used for surgical interventions and repairs related to tendon injuries in the shoulder area. 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 aligns with the documentation and the services provided.

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