2025 ICD-10-CM code M77.5
(Active) Effective Date: N/A Revision Date: N/A Musculoskeletal System - Other soft tissue disorders (M70-M79) Diseases of the musculoskeletal system and connective tissue (M00-M99) Feed
Other enthesopathy of the foot and ankle.
Modifiers may be applied depending on the circumstances of the encounter and the services provided.Consult the specific payer guidelines for modifier usage.
Medical necessity is supported by the presence of symptoms (pain, swelling, reduced function) and objective findings (on physical exam, imaging, or lab tests) consistent with enthesopathy.The severity of symptoms and impact on daily life justify the need for medical intervention.
Diagnosis and management of the condition involve taking a patient history, performing a physical examination, ordering appropriate imaging studies (X-rays, MRI, ultrasound) and laboratory tests (such as sedimentation rate and rheumatoid factor), and developing a treatment plan, including medication and physical therapy, to manage pain and inflammation and improve function.
- Diseases of the musculoskeletal system and connective tissue (M00-M99)
- M70-M79 (Other soft tissue disorders)
In simple words: This code describes a problem in the foot where tendons, ligaments, or muscles connect to the bone.It's caused by inflammation, and might involve pain, swelling, and stiffness. Doctors use X-rays, MRI scans, or other tests to diagnose this and manage it with medication or physical therapy.
M77.5, Other enthesopathy of foot and ankle, refers to a disorder affecting the sites where ligaments, tendons, or muscles attach to the bone or joint. This is a result of an inflammatory rheumatic or non-rheumatic disease.The specific type of enthesopathy is not specified under other codes.Clinical presentation includes tissue hardening from calcium deposits, inflammation, swelling around the affected foot area, and impaired functional activities. Diagnosis relies on patient history (pain), physical examination (range of motion), imaging (X-rays, MRI, ultrasound), and lab tests (sedimentation rate, rheumatoid factor) to identify underlying inflammatory disease. Treatment may involve analgesics, NSAIDs, and physical therapy.
Example 1: A 55-year-old female presents with chronic heel pain, worsened by activity.Physical exam reveals tenderness at the insertion of the Achilles tendon. X-rays show calcific tendinitis.M77.5 is coded., A 60-year-old male with a history of rheumatoid arthritis complains of pain and swelling in the plantar fascia.MRI confirms plantar fasciitis with enthesopathy at the calcaneal insertion. M77.5 is coded., A 40-year-old female athlete presents with persistent pain and limited range of motion in her foot after a running injury. Examination reveals enthesopathy at the insertion of the tibialis posterior. M77.5 is coded.
Detailed patient history including location, duration, and character of pain, aggravating and relieving factors. Physical exam findings including range of motion, palpation for tenderness, and assessment of functional limitations.Imaging studies (X-rays, MRI, ultrasound) to visualize the affected area and rule out other conditions. Lab results (e.g., ESR, RF) to assess inflammatory markers.
** This code is used for enthesopathies of the foot that don't fit into more specific categories.Precise documentation is crucial for accurate coding.
- Payment Status: Active
- Specialties:Rheumatology, Orthopedic Surgery, Podiatry
- Place of Service:Office, Outpatient Hospital, Clinic