ICD Code M66.331

ICD code M66.331 is used to classify and document a medical diagnosis of a spontaneous rupture of the flexor tendons in the right forearm. This condition refers to the sudden tearing or breaking of the tendons that are responsible for bending the fingers and wrist, without any apparent external trauma or injury. Such ruptures can lead to significant functional impairment, affecting the ability to perform everyday tasks that require gripping or holding objects. Proper documentation of this ICD code is crucial for healthcare providers to ensure accurate medical records, facilitate appropriate treatment plans, and streamline the billing process within the healthcare revenue cycle.

When to use the ICD code for spontaneous rupture of flexor tendons in the right forearm:

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

2. Patient Symptoms:
- Sudden onset of pain in the right forearm.
- Noticeable weakness or inability to flex the fingers or wrist on the affected side.
- Swelling or bruising in the forearm region.
- A palpable defect or gap in the tendon area upon physical examination.
- Limited range of motion in the fingers or wrist.

3. Imaging and Diagnostic Tests:
- MRI or ultrasound imaging confirms the diagnosis of tendon rupture.
- X-rays may be performed to rule out associated fractures or other injuries.

4. History of Injury:
- Patient reports a specific incident or activity that may have led to the rupture, such as a fall, sports injury, or repetitive strain.

5. Exclusion of Other Conditions:
- Other potential causes of similar symptoms (e.g., tendonitis, laceration, or other tendon injuries) have been ruled out through clinical assessment and diagnostic testing.

6. Treatment Plan:
- A treatment plan is established that may include surgical intervention, physical therapy, or other management strategies specific to the diagnosis of tendon rupture.

7. Follow-Up Care:
- Documentation of follow-up visits to monitor healing and recovery progress, confirming the ongoing relevance of the diagnosis.

Using the ICD code is appropriate when all of the above criteria are met, ensuring accurate coding for billing and clinical documentation purposes.

For the ICD code M66.331, which pertains to the spontaneous rupture of flexor tendons in the right forearm, the relevant CPT codes that may be applicable for treatment include:

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

2. CPT 25260 - Repair, tendon or muscle, flexor, forearm and/or wrist; primary, single, each tendon or muscle.

3. CPT 25270 - Repair, tendon or muscle, flexor, forearm and/or wrist; secondary, single, each tendon or muscle.

4. CPT 25310 - Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single.

5. CPT 24342 - Reinsertion of ruptured biceps or triceps tendon, distal, with or without tendon graft.

These CPT codes are typically used for surgical procedures related to the repair or reconstruction of tendons in the forearm and may be applicable depending on the specific treatment plan and surgical approach determined by the healthcare provider. Always consult with a coding specialist or refer to the latest CPT coding guidelines for the most accurate and applicable codes.

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