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ICD-10 Guide
ICD-10 CodesM61.021

M61.021

Billable

Myositis ossificans traumatica, right upper arm

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

Code Description

ICD-10 M61.021 is a billable code used to indicate a diagnosis of myositis ossificans traumatica, right 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 arises after an injury, such as a fracture or severe contusion, leading to inflammation and subsequent ossification in the affected area. In the case of the right upper arm, the muscle tissue may undergo calcification, resulting in pain, swelling, and restricted movement. 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 calcified masses within the muscle. Treatment usually involves 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 specific muscle disorders and their implications.
  • Differentiation from other types of myositis and ossification disorders.
  • Need for precise documentation of trauma history and clinical findings.
  • Potential for co-morbid conditions affecting muscle function.

Audit Risk Factors

  • Inadequate documentation of the traumatic event leading to myositis.
  • Failure to document the extent of muscle weakness or functional impairment.
  • Misclassification of the condition as a non-traumatic myositis.
  • Lack of imaging studies to support the diagnosis.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Post-traumatic cases following sports injuries or accidents.

Billing Considerations

Need for clear documentation of functional limitations and rehabilitation progress.

Physical Medicine and Rehabilitation

Documentation Requirements

Assessment of muscle strength, range of motion, and rehabilitation goals.

Common Clinical Scenarios

Patients undergoing rehabilitation after surgical intervention for myositis ossificans.

Billing Considerations

Focus on functional outcomes and long-term management strategies.

Coding Guidelines

Inclusion Criteria

Use M61.021 When
  • Follow official ICD
  • CM guidelines for coding myositis ossificans, ensuring accurate documentation of the traumatic event and the specific muscle group affected
  • Include any relevant co
  • morbid conditions

Exclusion Criteria

Do NOT use M61.021 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 needed due to associated swelling.

Documentation Requirements

Document the reason for aspiration and findings.

Specialty Considerations

Orthopedic documentation should include joint stability assessments.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 allows for more specific coding of myositis ossificans, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 allows for more specific coding of myositis ossificans, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    American Academy of Orthopaedic Surgeons

Coding & Billing References

  • •
    American Academy of Orthopaedic Surgeons

Frequently Asked Questions

What is myositis ossificans traumatica?

Myositis ossificans traumatica is a condition where bone tissue forms in muscle or connective tissue following trauma, leading to pain and functional impairment.