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ICD-10 Guide
ICD-10 CodesM61.03

M61.03

Billable

Myositis ossificans traumatica, forearm

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

Code Description

ICD-10 M61.03 is a billable code used to indicate a diagnosis of myositis ossificans traumatica, forearm.

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 a significant injury, such as a fracture or severe contusion, leading to inflammation and subsequent ossification in the affected area. In the forearm, this can result in pain, swelling, and restricted movement due to the formation of heterotopic bone. Clinically, patients may present with muscle weakness and stiffness, particularly in the affected limb, which can significantly impact their functional abilities. 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 if it leads to significant functional impairment. Understanding the underlying mechanisms of myositis ossificans is crucial for effective management and rehabilitation of affected individuals.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of specific trauma-related conditions
  • Differentiation from other types of myositis
  • Need for precise documentation of the traumatic event
  • Potential for co-existing conditions affecting coding

Audit Risk Factors

  • Inadequate documentation of the traumatic event
  • Failure to specify the location of ossification
  • Misclassification of myositis types
  • Lack of imaging studies to support diagnosis

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with post-traumatic pain and swelling in the forearm.

Billing Considerations

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

Physical Medicine and Rehabilitation

Documentation Requirements

Functional assessments, therapy progress notes, and pain management strategies.

Common Clinical Scenarios

Rehabilitation of patients post-surgery or those undergoing conservative management.

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use M61.03 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the traumatic event and the specific location of ossification
  • Include any relevant imaging studies and treatment plans in the medical record

Exclusion Criteria

Do NOT use M61.03 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 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 the accuracy of claims and facilitating better patient management.

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 claims and facilitating better patient management.

Reimbursement & Billing Impact

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

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 after trauma, leading to pain and restricted movement.

How is myositis ossificans diagnosed?

Diagnosis is typically made through clinical evaluation and imaging studies, such as X-rays or MRI, which show calcified tissue.

What are the treatment options for myositis ossificans?

Treatment may include physical therapy, pain management, and surgical intervention if necessary.