ICD Code M66.861

ICD code M66861 is used to classify and document a medical diagnosis of a spontaneous rupture of other tendons in the right lower leg. 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 term "spontaneous rupture" indicates that the tendon has torn or ruptured without any external trauma or injury, possibly due to underlying conditions or degenerative changes. This specific code helps healthcare providers accurately communicate the patient's condition for treatment planning, insurance claims, and statistical purposes.

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

1. Acute Onset of Pain: Sudden and severe pain in the right lower leg, often described as a "pop" or tearing sensation.

2. Swelling and Bruising: Noticeable swelling and bruising around the affected area, indicating inflammation and possible bleeding.

3. Limited Range of Motion: Difficulty or inability to move the ankle or foot, particularly when attempting to bear weight.

4. Tenderness on Palpation: Increased sensitivity and pain when the area around the tendon is touched or pressed.

5. Functional Impairment: Inability to perform normal activities, such as walking or running, due to pain or instability in the leg.

6. History of Overuse or Trauma: Recent history of repetitive strain, overexertion, or a specific traumatic event that may have led to the tendon rupture.

7. Diagnostic Imaging Findings: Confirmation through imaging studies (e.g., MRI or ultrasound) showing a complete or partial rupture of the tendon in the right lower leg.

8. Exclusion of Other Conditions: Ruling out other potential causes of leg pain or dysfunction, such as fractures, ligament injuries, or other tendon injuries.

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

For the ICD code M66.861, which pertains to the spontaneous rupture of other tendons in the right lower leg, the relevant CPT codes that may be applicable for treatment include:

1. 27385 - Suture of infrapatellar tendon.

2. 27650 - Repair, primary, open or percutaneous, and/or exploration (with or without removal of foreign body), of ruptured Achilles tendon; without graft.

3. 27652 - Repair, primary, open or percutaneous, and/or exploration (with or without removal of foreign body), of ruptured Achilles tendon; with graft (includes obtaining graft).

4. 27654 - Repair, secondary, Achilles tendon, with or without graft.

5. 27658 - Repair, flexor tendon, leg; primary, without graft, each tendon.

6. 27659 - Repair, flexor tendon, leg; secondary, with or without graft, each tendon.

7. 27664 - Repair, extensor tendon, leg; primary, without graft, each tendon.

8. 27665 - Repair, extensor tendon, leg; secondary, with or without graft, each tendon.

These CPT codes are commonly associated with procedures that address tendon ruptures in the lower leg, and the selection of the appropriate code would depend on the specific tendon involved and the nature of the surgical intervention required. Always ensure to verify with the latest coding guidelines and payer-specific policies.

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