ICD Code M66.261

ICD code M66.261 is used to classify and document a medical diagnosis of a spontaneous rupture of extensor tendons in the right lower leg. This condition involves the sudden tearing or breaking of the tendons that extend or straighten the foot and toes, without any apparent external trauma or injury. Such ruptures can lead to pain, swelling, and difficulty in moving the affected limb, and they may require medical intervention such as physical therapy or surgery to restore function. This code is crucial for healthcare providers to accurately record the condition for treatment planning, billing, and insurance purposes.

When to use the ICD code for spontaneous rupture of extensor tendons in the right lower leg, consider the following diagnostic criteria and symptoms:

1. Patient History
- Recent trauma or injury to the right lower leg.
- History of repetitive stress or overuse in the affected area.

2. Physical Examination Findings
- Visible deformity or abnormal positioning of the toes or foot.
- Swelling or bruising around the ankle or foot.

3. Pain Assessment
- Acute pain in the right lower leg, particularly during movement.
- Pain that worsens with activity or pressure on the affected area.

4. Functional Limitations
- Difficulty in extending the toes or foot.
- Inability to perform normal activities such as walking or running.

5. Diagnostic Imaging
- MRI or ultrasound confirming the rupture of extensor tendons.
- X-rays to rule out associated fractures or other injuries.

6. Symptoms of Complications
- Signs of infection, such as increased redness, warmth, or discharge.
- Neurological symptoms like numbness or tingling in the foot.

7. Response to Conservative Treatment
- Lack of improvement with rest, ice, compression, and elevation (RICE) methods.
- Persistent symptoms despite physical therapy interventions.

These criteria should guide healthcare providers in determining the appropriate use of the ICD code for this specific condition.

For the ICD code M66.261, which pertains to the spontaneous rupture of extensor tendons in the right lower leg, the relevant CPT codes that may be applicable for treatment include:

1. 27650 - Repair, primary, open or percutaneous, of ruptured Achilles tendon; without graft.

2. 27652 - Repair, primary, open or percutaneous, of ruptured Achilles tendon; with graft (includes obtaining graft).

3. 27654 - Repair, secondary, Achilles tendon, with or without graft.

4. 27658 - Repair, flexor tendon, leg; primary, without graft, each tendon.

5. 27659 - Repair, flexor tendon, leg; secondary, with or without graft, each tendon.

6. 27664 - Repair, extensor tendon, leg; primary, without graft, each tendon.

7. 27665 - Repair, extensor tendon, leg; secondary, with or without graft, each tendon.

These CPT codes are typically used to describe the surgical procedures involved in repairing tendon ruptures in the lower leg. It is important for healthcare providers to select the appropriate CPT code based on the specific procedure performed and the clinical scenario. Accurate coding is essential for proper billing and reimbursement in the healthcare revenue cycle management process.

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