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ICD-10 Guide
ICD-10 CodesM61.02

M61.02

Billable

Myositis ossificans traumatica, upper arm

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

Code Description

ICD-10 M61.02 is a billable code used to indicate a diagnosis of myositis ossificans traumatica, upper arm.

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 in the upper arm following an injury, such as a fracture or severe contusion. The process begins with inflammation of the muscle tissue, which can lead to muscle weakness and impaired mobility. Over time, the inflammatory response can stimulate the formation of ectopic bone, which can further restrict movement and cause pain. Clinically, patients may present with swelling, tenderness, and decreased range of motion in the affected arm. Diagnosis is often confirmed through imaging studies, such as X-rays or MRI, which reveal the presence of calcified tissue within the muscle. Treatment may involve physical therapy, pain management, and in some cases, surgical intervention to remove the ossified tissue. Understanding the nuances of this condition is crucial for accurate coding and appropriate management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of specific anatomical locations (upper arm).
  • Differentiation from other types of myositis and ossification disorders.
  • Need for precise documentation of trauma history.
  • Potential for co-morbid conditions affecting muscle function.

Audit Risk Factors

  • Inadequate documentation of trauma history.
  • Failure to specify the location of ossification.
  • Misclassification of myositis types.
  • Lack of imaging reports to support diagnosis.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed injury history, imaging results, and treatment plans.

Common Clinical Scenarios

Post-traumatic evaluation of upper arm injuries, surgical intervention for ossification.

Billing Considerations

Documentation must clearly outline the relationship between trauma and ossification.

Physical Medicine and Rehabilitation

Documentation Requirements

Functional assessments, therapy progress notes, and patient-reported outcomes.

Common Clinical Scenarios

Rehabilitation following trauma to the upper arm with myositis ossificans.

Billing Considerations

Focus on functional limitations and recovery goals.

Coding Guidelines

Inclusion Criteria

Use M61.02 When
  • Follow official ICD
  • CM guidelines for coding myositis ossificans, ensuring accurate documentation of the traumatic event and its impact on muscle function
  • Include any relevant co
  • morbid conditions that may affect treatment

Exclusion Criteria

Do NOT use M61.02 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 when joint aspiration is necessary due to swelling from myositis ossificans.

Documentation Requirements

Document the reason for aspiration and findings.

Specialty Considerations

Orthopedic specialists may frequently perform this procedure.

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 data accuracy and facilitating better patient management through detailed documentation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like myositis ossificans, improving data accuracy and facilitating better patient management through detailed documentation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like myositis ossificans, improving data accuracy and facilitating better patient management through detailed documentation.

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 within muscle due to trauma, leading to pain and restricted movement.