ICD-10 Coding for Biceps Tendon Rupture(M66.821, M66.821B, M66.821S)

Comprehensive guide on ICD-10 coding for biceps tendon rupture, including traumatic and spontaneous cases, with documentation tips.

Also known as:
Biceps TearDistal Biceps RuptureProximal Biceps Rupture
Related ICD-10 Code Ranges

Complete code families applicable to Biceps Tendon Rupture

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescription
S46.11XATraumatic rupture of right long head of biceps, initial encounter
M66.821Spontaneous rupture of right upper arm tendon

Clinical Decision Support

Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.

Key Information

Essential facts and insights aboutBiceps Tendon Rupture

Differential Codes

Alternative codes to consider when ruling out similar conditions

Spontaneous rupture of right upper arm tendonM66.821
Traumatic rupture of right long head of biceps, initial encounterS46.11X

Documentation & Coding Risks

Avoid these common issues when documenting Biceps Tendon Rupture.

Vague documentation of symptoms

Impact

Clinical: Leads to incorrect diagnosis and treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials.

Mitigation

Use specific clinical terms and imaging results.

Mixing traumatic and nontraumatic codes

Impact

Reimbursement: Incorrect coding can lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.

Mitigation

Ensure documentation clearly specifies the cause of rupture.

Incorrect code selection

Impact

Using the wrong code for the type of rupture.

Mitigation

Ensure documentation clearly differentiates between traumatic and nontraumatic causes.

Frequently Asked Questions