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ICD-10 Guide
ICD-10 CodesM61.221

M61.221

Billable

Paralytic calcification and ossification of muscle, right upper arm

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/17/2025

Code Description

ICD-10 M61.221 is a billable code used to indicate a diagnosis of paralytic calcification and ossification of muscle, right upper arm.

Key Diagnostic Point:

Paralytic calcification and ossification of muscle, specifically in the right upper arm, refers to the pathological process where muscle tissue undergoes calcification and ossification due to paralysis. This condition often arises from prolonged immobilization or disuse of the affected muscle, leading to the deposition of calcium salts and subsequent bone-like changes in the muscle tissue. Clinically, patients may present with muscle weakness, stiffness, and reduced range of motion in the right upper arm. The condition can be associated with various neuromuscular disorders, including myositis, where inflammation of the muscle may precede or accompany the calcification process. Diagnosis typically involves imaging studies such as X-rays or MRI to visualize the calcified areas, alongside clinical evaluation of muscle strength and function. Management may include physical therapy to improve mobility and strength, as well as addressing the underlying cause of paralysis.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Specificity of the location (right upper arm) required for accurate coding.
  • Differentiation from other muscle disorders that may present similarly.
  • Need for comprehensive documentation of the underlying cause of paralysis.
  • Potential for co-existing conditions that may complicate the diagnosis.

Audit Risk Factors

  • Inadequate documentation of the paralysis cause.
  • Failure to specify the affected muscle location.
  • Misinterpretation of imaging results leading to incorrect coding.
  • Lack of evidence for the duration of immobilization or disuse.

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological assessment and history of muscle weakness or paralysis.

Common Clinical Scenarios

Patients with neuromuscular disorders presenting with muscle weakness and calcification.

Billing Considerations

Documentation should include the neurological evaluation and any relevant imaging studies.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive rehabilitation plans and progress notes detailing physical therapy interventions.

Common Clinical Scenarios

Patients undergoing rehabilitation for muscle weakness due to paralysis.

Billing Considerations

Focus on functional outcomes and the impact of calcification on rehabilitation goals.

Coding Guidelines

Inclusion Criteria

Use M61.221 When
  • According to ICD
  • 10 coding guidelines, M61
  • 221 should be used when there is clear documentation of paralytic calcification and ossification specifically in the right upper arm
  • Coders should ensure that the underlying cause of paralysis is documented and that the condition is not a result of trauma or other acute injuries

Exclusion Criteria

Do NOT use M61.221 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

97110CPT Code

Therapeutic exercises

Clinical Scenario

Used in conjunction with M61.221 for rehabilitation of muscle strength.

Documentation Requirements

Documentation of the therapeutic exercises performed and progress notes.

Specialty Considerations

Physical therapy notes should detail the specific exercises and patient response.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like M61.221, improving the accuracy of patient records and facilitating better management of muscle disorders. The specificity helps in tracking outcomes and resource allocation in healthcare settings.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like M61.221, improving the accuracy of patient records and facilitating better management of muscle disorders. The specificity helps in tracking outcomes and resource allocation in healthcare settings.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like M61.221, improving the accuracy of patient records and facilitating better management of muscle disorders. The specificity helps in tracking outcomes and resource allocation in healthcare settings.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the primary cause of paralytic calcification?

The primary cause of paralytic calcification is prolonged immobilization or disuse of the affected muscle, often due to neurological conditions or injuries that result in paralysis.