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ICD-10 Guide
ICD-10 CodesM61.042

M61.042

Billable

Myositis ossificans traumatica, left hand

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

Code Description

ICD-10 M61.042 is a billable code used to indicate a diagnosis of myositis ossificans traumatica, left hand.

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 a significant injury, such as a fracture or severe contusion, leading to inflammation and subsequent calcification of the affected muscle. In the case of myositis ossificans traumatica of the left hand, the condition may manifest as localized pain, swelling, and reduced range of motion in the affected area. Patients may experience muscle weakness due to the infiltration of bone into muscle tissue, which can hinder normal muscle function. 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. Understanding the underlying mechanisms of muscle disorders and neuromuscular conditions is crucial for effective management and rehabilitation of affected individuals.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires precise documentation of trauma history.
  • Differentiation from other types of myositis.
  • Need for imaging studies to confirm diagnosis.
  • Potential for co-existing conditions affecting muscle function.

Audit Risk Factors

  • Inadequate documentation of trauma history.
  • Failure to document imaging results.
  • Lack of clarity on the extent of muscle weakness.
  • Misclassification of myositis type.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed notes on injury mechanism, imaging results, and treatment plans.

Common Clinical Scenarios

Post-traumatic evaluations, surgical interventions for ossification removal.

Billing Considerations

Consideration of functional outcomes and rehabilitation needs.

Physical Medicine and Rehabilitation

Documentation Requirements

Assessment of muscle strength, range of motion, and functional limitations.

Common Clinical Scenarios

Rehabilitation following trauma, management of pain and mobility.

Billing Considerations

Focus on long-term recovery and functional restoration.

Coding Guidelines

Inclusion Criteria

Use M61.042 When
  • Follow ICD
  • CM guidelines for coding myositis ossificans, ensuring accurate documentation of the traumatic event and any associated conditions
  • Include any relevant imaging findings and treatment plans

Exclusion Criteria

Do NOT use M61.042 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 joint involved, reason for aspiration/injection, and patient response.

Specialty Considerations

Orthopedic specialists may 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 patient records and facilitating better treatment planning.

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 patient records and facilitating better treatment planning.

Reimbursement & Billing Impact

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

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 connective tissue following trauma, leading to pain and functional impairment.