ICD Code M66.312

ICD code M66.312 is used to classify and document a medical diagnosis of a spontaneous rupture of the flexor tendons in the left shoulder. This code is part of the International Classification of Diseases, 10th Revision (ICD-10), which is a system used by healthcare providers to standardize the diagnosis of medical conditions. A spontaneous rupture indicates that the tendon has torn without any external trauma or injury, often due to underlying conditions such as tendon degeneration or overuse. The flexor tendons are responsible for bending movements, and their rupture can lead to significant impairment in shoulder function, requiring medical evaluation and possibly surgical intervention.

When to use the ICD code for spontaneous rupture of flexor tendons in the left shoulder:

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

2. Patient Symptoms:

- Sudden onset of pain in the left shoulder.

- Limited range of motion in the left shoulder.

- Swelling or tenderness in the left shoulder area.

- Weakness or inability to flex the fingers or wrist on the affected side.

- Possible audible "pop" or snapping sound at the time of injury.

3. Imaging and Diagnostic Tests:

- MRI or ultrasound imaging confirms the presence of a rupture in the flexor tendons of the left shoulder.

- Physical examination findings consistent with tendon rupture.

4. Exclusion of Other Conditions:

- Other potential causes of shoulder pain (e.g., fractures, dislocations, or other tendon injuries) have been ruled out through clinical assessment and imaging.

5. Treatment Plan:

- A treatment plan has been established that may include surgical intervention or conservative management based on the severity of the rupture.

6. Follow-Up Care:

- Documentation of follow-up visits to monitor recovery and rehabilitation progress related to the tendon injury.

Using the ICD code is appropriate when these diagnostic criteria and symptoms are present, ensuring accurate coding for billing and clinical documentation purposes.

For the ICD code M66.312, which pertains to the spontaneous rupture of flexor tendons in the left 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. 24342 - Reinsertion of ruptured biceps or triceps tendon, distal, with or without tendon graft.

These CPT codes are typically used for surgical interventions related to tendon repair in the shoulder area. The selection of the appropriate CPT code will depend on the specific surgical procedure performed and the clinical scenario. Always ensure that the coding is aligned with the latest coding guidelines and payer-specific requirements.

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