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ICD-10 Guide
ICD-10 CodesM61.011

M61.011

Billable

Myositis ossificans traumatica, right shoulder

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

Code Description

ICD-10 M61.011 is a billable code used to indicate a diagnosis of myositis ossificans traumatica, right shoulder.

Key Diagnostic Point:

Myositis ossificans traumatica is a condition characterized by the abnormal formation of bone tissue within muscle or connective tissue following trauma. This condition typically occurs after an injury, such as a fracture or severe contusion, leading to inflammation and subsequent calcification of the affected muscle. In the case of the right shoulder, the muscle tissue surrounding the shoulder joint may undergo this pathological process, resulting in pain, swelling, and restricted range of motion. Patients may experience muscle weakness due to the compromised function of the affected muscles. Diagnosis is often confirmed through imaging studies, such as X-rays or MRI, which reveal the presence of heterotopic ossification. Treatment may involve physical therapy, pain management, and in some cases, surgical intervention to remove the ossified tissue if it significantly impairs function. Understanding the underlying muscle disorders and neuromuscular conditions is crucial for effective management and rehabilitation of patients with myositis ossificans.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of muscle pathology and trauma-related conditions.
  • Differentiation from other forms of myositis and ossification.
  • Need for precise documentation of the location and nature of the injury.
  • Potential for co-morbid conditions affecting muscle function.

Audit Risk Factors

  • Inadequate documentation of the traumatic event leading to myositis.
  • Failure to specify the affected muscle group accurately.
  • Misinterpretation of imaging results leading to incorrect coding.
  • Lack of follow-up documentation on treatment and outcomes.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed history of trauma, imaging results, and treatment plans.

Common Clinical Scenarios

Post-traumatic shoulder pain with restricted movement.

Billing Considerations

Ensure accurate documentation of the mechanism of injury and any surgical interventions.

Physical Medicine and Rehabilitation

Documentation Requirements

Functional assessments, therapy progress notes, and patient response to treatment.

Common Clinical Scenarios

Rehabilitation following surgical removal of ossified tissue.

Billing Considerations

Documenting the impact of myositis on functional abilities and rehabilitation goals.

Coding Guidelines

Inclusion Criteria

Use M61.011 When
  • According to ICD
  • 10 guidelines, M61
  • 011 should be used when myositis ossificans is specifically due to trauma and located in the right shoulder
  • Coders must ensure that the documentation supports the diagnosis and that the injury is well
  • documented

Exclusion Criteria

Do NOT use M61.011 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

20610CPT Code

Arthrocentesis, aspiration and/or injection into a major joint or bursa

Clinical Scenario

Used for pain management in cases of myositis ossificans.

Documentation Requirements

Document the indication for the procedure and the patient's response.

Specialty Considerations

Orthopedic specialists may perform this procedure to alleviate symptoms.

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 myositis ossificans, improving the accuracy of diagnosis and treatment tracking. This specificity aids in better patient management and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like myositis ossificans, improving the accuracy of diagnosis and treatment tracking. This specificity aids in better patient management and resource allocation.

Reimbursement & Billing Impact

reimbursement and to avoid denials.

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 myositis ossificans traumatica?

Myositis ossificans traumatica is a condition where bone tissue forms in muscle or soft tissue following trauma, leading to pain and restricted movement.

How is myositis ossificans diagnosed?

Diagnosis is typically made through imaging studies such as X-rays or MRI, which reveal calcification in the affected muscle.

What are the treatment options for myositis ossificans?

Treatment may include physical therapy, pain management, and in some cases, surgical removal of the ossified tissue.

What documentation is required for coding M61.011?

Documentation must include a detailed history of the trauma, imaging results, and treatment plans to support the diagnosis.