ICD Code M67.261

ICD code M67261 is used to identify a medical condition known as synovial hypertrophy, specifically affecting the right lower leg. Synovial hypertrophy refers to the abnormal enlargement or thickening of the synovial membrane, which is the soft tissue lining the spaces of diarthrodial joints, tendon sheaths, and bursae. This condition can lead to joint pain, swelling, and reduced mobility. The code M67261 is part of the International Classification of Diseases (ICD) system, which is used by healthcare providers to standardize the diagnosis and classification of diseases for billing, reporting, and statistical purposes. The designation "not elsewhere classified" indicates that this specific condition does not fit into other predefined categories within the ICD coding system.

When to use the ICD code for synovial hypertrophy, not elsewhere classified, right lower leg:

1. Presence of Synovial Hypertrophy
- Observed swelling or thickening of the synovial membrane in the right lower leg.

2. Localized Symptoms
- Pain or discomfort in the right lower leg, particularly around the joints.
- Stiffness or reduced range of motion in the affected area.

3. Exclusion of Other Conditions
- Rule out other potential causes of joint swelling or pain, such as arthritis, bursitis, or infections.

4. Duration of Symptoms
- Symptoms persisting for a significant period, typically more than a few weeks, indicating a chronic condition.

5. Diagnostic Imaging Findings
- Imaging studies (e.g., MRI, ultrasound) showing evidence of synovial thickening without identifiable underlying pathology.

6. Clinical Evaluation
- Comprehensive assessment by a healthcare provider confirming the diagnosis based on physical examination and patient history.

7. Impact on Daily Activities
- Notable interference with daily activities or quality of life due to the symptoms associated with synovial hypertrophy.

8. Response to Treatment
- Lack of improvement or resolution of symptoms despite conservative management, such as rest, ice, or anti-inflammatory medications.

Using the ICD code is appropriate when these diagnostic criteria and symptoms are present, ensuring accurate documentation and billing for the condition.

For the ICD code M67.261, which pertains to synovial hypertrophy of the right lower leg, the relevant CPT codes that may be applicable for treatment include:

1. 20610 - Arthrocentesis, aspiration, and/or injection into a major joint or bursa (e.g., knee, hip, shoulder joint); without ultrasound guidance.

2. 20611 - Arthrocentesis, aspiration, and/or injection into a major joint or bursa (e.g., knee, hip, shoulder joint); with ultrasound guidance, with permanent recording and reporting.

3. 29881 - Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving).

4. 29882 - Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral).

5. 29883 - Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving).

6. 29884 - Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure).

7. 29885 - Arthroscopy, knee, surgical; synovectomy, partial.

8. 29886 - Arthroscopy, knee, surgical; synovectomy, complete.

These CPT codes are commonly associated with procedures that might be performed to address conditions related to synovial hypertrophy in the lower leg. It is important for healthcare providers to select the appropriate CPT code based on the specific procedure performed and the clinical scenario. Always ensure that the chosen CPT code aligns with the documentation and the services provided.

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