ICD Code M66.851

ICD code M66851 is used to classify and document a medical diagnosis of a spontaneous rupture of other tendons in the right thigh. 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 for medical conditions. The code specifically indicates that the rupture occurred without any external trauma or injury, affecting tendons in the right thigh that are not otherwise specified in other ICD codes. This information is crucial for accurate medical records, treatment planning, and insurance claims processing.

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

1. Acute Onset of Pain: Sudden and severe pain in the right thigh, often described as a tearing sensation.

2. Swelling and Bruising: Noticeable swelling and bruising in the area surrounding the tendon, indicating possible hemorrhage.

3. Limited Range of Motion: Difficulty or inability to move the affected leg, particularly in activities that require the use of the thigh muscles.

4. Palpable Defect: A noticeable gap or defect in the tendon when palpating the area, suggesting a rupture.

5. Functional Impairment: Inability to perform normal activities, such as walking or climbing stairs, due to pain and weakness in the thigh.

6. History of Trauma: Recent history of trauma or overuse that may have contributed to the tendon rupture.

7. Diagnostic Imaging Findings: Confirmation of the rupture through imaging studies such as MRI or ultrasound, showing discontinuity of the tendon fibers.

8. Exclusion of Other Conditions: Ruling out other potential causes of thigh pain, such as fractures, muscle tears, or other tendon injuries.

These criteria should be carefully evaluated to determine the appropriate use of the ICD code.

For the ICD code M66.851, which refers to the spontaneous rupture of other tendons in the right thigh, the relevant CPT codes that may be applicable for treatment could include:

1. 27385 - Suture of infrapatellar tendon.

2. 27386 - Suture of quadriceps or hamstring muscle rupture; primary.

3. 27393 - Repair, extensor mechanism disruption of the knee; primary.

4. 27650 - Repair, primary, open or percutaneous, of ruptured Achilles tendon.

5. 27652 - Repair, primary, open or percutaneous, with graft, of ruptured Achilles tendon.

These CPT codes are examples of procedures that might be performed to address tendon ruptures in the thigh area. The specific code used would depend on the exact nature and location of the rupture, as well as the surgical approach taken 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.

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 codes like M66851. Schedule a demo today to see how RevFind can help ensure you're receiving the full reimbursement you deserve.