ICD Code M66.342

ICD code M66.342 is used to classify and document the medical condition known as the spontaneous rupture of flexor tendons in the left hand. This code is part of the International Classification of Diseases, 10th Revision (ICD-10), which is a standardized system used by healthcare providers to ensure consistent documentation and billing. The condition described by this code involves the sudden tearing or breaking of the tendons responsible for bending the fingers, without any apparent external trauma or injury, specifically affecting the left hand. Proper coding of this condition is crucial for accurate medical records, treatment planning, and insurance reimbursement.

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

1. Clinical Diagnosis: Confirmed diagnosis of spontaneous rupture of flexor tendons in the left hand by a qualified healthcare provider.

2. Symptoms Present:

- Sudden onset of pain in the left hand.

- Inability to flex the fingers of the left hand.

- Swelling or bruising in the area of the left hand.

- Tenderness upon palpation of the affected tendons.

- A noticeable gap or defect in the tendon upon physical examination.

3. Imaging Results: Supporting imaging studies (e.g., MRI or ultrasound) that confirm the rupture of the flexor tendons in the left hand.

4. Patient History: Documentation of any relevant history that may contribute to the diagnosis, such as:

- Previous injuries to the left hand.

- Chronic conditions affecting tendon integrity (e.g., rheumatoid arthritis).

- Recent activities that may have led to the injury (e.g., sports, heavy lifting).

5. Treatment Plan: A treatment plan that includes surgical or non-surgical intervention specifically addressing the spontaneous rupture of the flexor tendons in the left hand.

6. Follow-Up Care: Evidence of follow-up assessments that monitor the condition and recovery of the left hand post-diagnosis.

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

For the ICD code M66.342, which pertains to the spontaneous rupture of flexor tendons in the left hand, the relevant CPT codes that may be applicable for treatment include:

1. CPT 26356 - Repair or advancement, flexor tendon, in the hand, each tendon.

2. CPT 26350 - Repair of flexor tendon, in the hand, primary or secondary, without free graft, each tendon.

3. CPT 26418 - Repair of flexor tendon, in the hand, secondary, with free graft (includes obtaining graft), each tendon.

4. CPT 26410 - Repair of flexor tendon, in the hand, primary, with free graft (includes obtaining graft), each tendon.

5. CPT 26055 - Tendon sheath incision (e.g., for trigger finger).

These CPT codes are typically used for surgical interventions related to tendon repair in the hand. The specific code selection would depend on the exact nature of the procedure performed, including whether a graft is used and whether the repair is primary or secondary. Always consult with a coding specialist or refer to the latest CPT coding guidelines to ensure accurate coding for specific clinical scenarios.

Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately reading your contracts and detecting underpayments for CPT codes associated with ICD code M66342. Ensure you're receiving the full reimbursement you deserve. Schedule a demo today to see RevFind in action and safeguard your practice's financial health.