ICD-10-CM · Knee

M66.0

M66.0 classifies spontaneous rupture of a popliteal (Baker's) cyst — the dissection or decompression of a synovial fluid-filled cyst in the posterior knee space that occurs when normal force is applied to already-weakened tissue.

Verified May 8, 2026 · 4 sources ↓

Status
Billable
Chapter
13
Related CPT
5
Region
Knee
Drawn from CDCICD10DataAAPCCMS

Documentation tips

What should appear in the chart to support M66.0.

Source · Editorial brief grounded in 4 cited references ↓

  • State explicitly that the cyst has ruptured, not merely that it is present — 'ruptured popliteal cyst with fluid dissecting into the calf' supports M66.0; 'Baker's cyst' alone maps to M71.2x.
  • Record the affected side (right, left, or bilateral) in the note; while M66.0 has no laterality subcode, documentation supports audit defense and clinical continuity.
  • Include the imaging modality and findings (e.g., ultrasound or MRI confirming posterior knee cyst with fluid tracking distally into the gastrocnemius-soleus plane) to substantiate the rupture diagnosis.
  • Document that DVT was considered or excluded if calf swelling is the presenting complaint — this supports clinical decision-making and justifies any associated diagnostic workup.
  • Note the underlying joint pathology (e.g., knee OA, meniscal tear, rheumatoid arthritis) that predisposed to cyst formation; code those conditions as additional diagnoses to complete the clinical picture.

Related CPT procedures

Procedure codes commonly billed with M66.0. Linking the right diagnosis to the right procedure is what establishes medical necessity.

Source · CMS LCDs · AAOS specialty guidance · claims-pattern analysis

Common coding pitfalls

The recurring mistakes coders make with M66.0 and adjacent codes.

Source · Editorial brief grounded in CDC ICD-10-CM tabular guidance, AAOS coding references, and cited references ↓

  • Using M71.21 or M71.22 (intact Baker's cyst) when the cyst has ruptured — these codes carry a Type 1 Excludes note blocking their use with M66.0 for the same episode.
  • Coding M66.0 for a cyst that is large or symptomatic but not confirmed ruptured — if rupture is not documented or confirmed by imaging, default to the appropriate M71.2x laterality code.
  • Confusing M66.0 with M66.1x (rupture of synovium, other joints) — M66.1 carries a Type 2 Excludes specifically excluding rupture of popliteal cyst, which belongs only at M66.0.
  • Failing to code the underlying knee condition (e.g., M17.11 primary OA right knee, M23.x meniscal tear) as an additional diagnosis, which leaves the clinical picture incomplete and may trigger medical necessity questions.

Clinical context

Source · Editorial summary grounded in 4 cited references ↓

Use M66.0 when the popliteal cyst has actually ruptured — fluid has dissected into the calf — not simply when a Baker's cyst is present and intact. An intact or unruptured Baker's cyst codes to M71.21 (right) or M71.22 (left). The ICD-10-CM Tabular List places a Type 1 Excludes note at M71.2 pointing to M66.0 precisely to enforce this distinction: you cannot use M71.2x and M66.0 together for the same cyst episode.

M66.0 carries no laterality subcode — it is the only billable code in the M66.0 slot and does not extend to a 5th or 6th character for right/left/bilateral. Approximate synonyms in the index do include rupture of right, left, and bilateral popliteal cysts, so laterality should still be documented in the note even though the code itself is not laterality-differentiated.

Clinically, a ruptured popliteal cyst can mimic deep vein thrombosis (calf swelling, tenderness, erythema). If DVT has been ruled out and imaging confirms cyst rupture — typically via ultrasound or MRI — M66.0 is the appropriate primary diagnosis. The condition sits under category M66 (Spontaneous rupture of synovium and tendon), which covers ruptures that occur when normal forces act on tissue with less-than-normal structural integrity. It groups to MS-DRG 557/558 (Tendonitis, myositis and bursitis with/without MCC).

Sibling codes

Other billable codes under M66 (laterality / anatomic variants).

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 4 cited references ↓

01Does M66.0 have a right/left/bilateral breakdown?
No. M66.0 is a single billable code with no laterality subcodes. Document the affected side in the clinical note for audit support, but the code itself does not differentiate right from left.
02Can I use M66.0 and M71.21 or M71.22 together for the same knee?
No. The Tabular List places a Type 1 Excludes note at M71.2 that explicitly excludes synovial cyst of popliteal space with rupture, directing you to M66.0. These codes are mutually exclusive for the same cyst episode.
03What is the difference between M66.0 and M66.1x?
M66.0 is specific to rupture of the popliteal cyst. M66.1x covers rupture of synovium at other joints (shoulder, elbow, wrist, hand, etc.). M66.1 carries a Type 2 Excludes note that explicitly carves out rupture of popliteal cyst to M66.0.
04Should I code the underlying knee condition separately?
Yes. The condition that caused the synovial effusion and cyst — such as knee OA, a meniscal tear, or inflammatory arthritis — should be coded as an additional diagnosis. M66.0 captures the rupture event but not its etiology.
05Which MS-DRGs does M66.0 group to?
M66.0 groups to MS-DRG 557 (Tendonitis, myositis and bursitis with MCC) or 558 (without MCC) under MS-DRG v43.0, per the ICD-10-CM grouper crosswalk.
06Is M66.0 appropriate when a popliteal cyst rupture is suspected but not yet confirmed by imaging?
Only if the treating provider documents the diagnosis as confirmed. If rupture is uncertain and imaging has not yet been performed, code the presenting symptoms (e.g., posterior knee pain, calf swelling) until the diagnosis is established.
07Does CMS recognize M66.0 as supporting medical necessity for any specific procedures?
Yes. CMS article A56766 lists M66.0 among the ICD-10-CM codes that support medical necessity for incision and drainage procedures, alongside intact Baker's cyst codes M71.21 and M71.22.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

  1. 01CDC ICD-10-CM Tabular List 2026 (effective Oct 1, 2025)
  2. 02
    icd10data.com
    https://www.icd10data.com/ICD10CM/Codes/M00-M99/M65-M67/M66-/M66.0
  3. 03
    aapc.com
    https://www.aapc.com/codes/icd-10-codes/M66.0
  4. 04
    cms.gov
    https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56766&ver=24

Mira AI Scribe

Mira AI Scribe captures the posterior knee cyst history, confirmation of rupture (ultrasound or MRI findings showing fluid dissection into the calf), laterality, and any underlying joint pathology driving cyst formation. This prevents the encounter from defaulting to the unruptured Baker's cyst codes (M71.21/M71.22), which are excluded when rupture is confirmed, and avoids a medical necessity gap when DVT workup is also documented.

See how Mira captures M66.0 documentation

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