ICD Code M66.862

ICD code M66.862 is used to classify and document a medical diagnosis where there is a spontaneous rupture of a tendon located in the left lower leg. This code is part of the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM), which is used by healthcare providers to ensure accurate billing and efficient communication of patient conditions. The term "spontaneous rupture" indicates that the tendon has torn without any apparent external trauma or injury, which can occur due to underlying conditions such as tendon degeneration or overuse. This specific code helps in the precise documentation of the patient's condition, facilitating appropriate treatment plans and insurance claims processing.

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

1. Acute Onset of Pain: Sudden and severe pain in the left 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 hemorrhage.

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

4. Palpable Defect: A noticeable gap or defect in the tendon upon physical examination, which may be felt when palpating the area.

5. Functional Impairment: Inability to bear weight on the affected leg or perform normal activities due to pain and instability.

6. History of Trauma: Recent history of trauma or overuse that may have contributed to the tendon rupture, such as a fall, sports injury, or sudden increase in physical activity.

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

8. Exclusion of Other Conditions: Ruling out other potential causes of pain and dysfunction in the left lower leg, such as fractures, ligament injuries, or other tendon pathologies.

These criteria should guide healthcare providers in determining the appropriate use of the ICD code for this specific condition.

For the ICD code M66.862, which pertains to the spontaneous rupture of other tendons in the left lower leg, the relevant CPT codes that may be applicable for treatment could include:

1. 27385 - Suture of infrapatellar tendon (e.g., quadriceps, patellar tendon) with or without graft.

2. 27650 - Repair, primary, open or percutaneous, of ruptured Achilles tendon.

3. 27652 - Repair, primary, open or percutaneous, with graft (includes obtaining graft), of ruptured Achilles tendon.

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 examples of procedures that may be performed to address tendon ruptures in the lower leg, depending on the specific tendon involved and the nature of the rupture. It is important for healthcare providers to select the appropriate CPT code based on the specific clinical scenario and surgical procedure performed.

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