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Coding tip: Know distinctions between types of synovitis

Ambulatory Surgery Reimbursement Update, September 25, 2007

The word synovium comes from the Latin word meaning "with egg". The synovial fluid in the joint is like that of an egg white. It involves the inflammation of the synovial lining that keeps foreign matter out of the joints and produces joint fluid for lubrication of joints such as the knee, shoulder, hip, elbow, wrist or ankle.

Orthopedic surgeons and podiatrists are usually the types of physicians who perform procedures involving synovitis or Plica Syndrome (code 727.83) conditions. Coders should code the synovitis condition from the 727.0X Synovitis or Tenosynovitis section. For the hand or wrist area, use code 727.05. For the foot or ankle, use code 727.06. Code 727.00 for the typical synovitis seen.

Villonodular synovitis should not be confused and coded for the usual type of synovitis conditions found, since it is a rare condition. Pigmented villonodular synovitis is an inflammatory reaction of the synovium, and also includes fluid retention. Specifically indicate a villonodular synovitis diagnosis in the operative report or pathology report as pigmented villonodular synovitis, in order to code it (719.2X).

This tip is brought to you by Ellis Medical Consulting, Inc.

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