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ICD-10 Guide
ICD-10 CodesM61.052

M61.052

Billable

Myositis ossificans traumatica, left thigh

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

Code Description

ICD-10 M61.052 is a billable code used to indicate a diagnosis of myositis ossificans traumatica, left thigh.

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 ossification in the affected area. In the case of M61.052, the condition specifically affects the left thigh. Patients may present with localized pain, swelling, and reduced range of motion in the thigh muscle. The ossification can lead to muscle weakness and functional impairment, complicating rehabilitation efforts. Diagnosis is often confirmed through imaging studies, such as X-rays or MRI, which reveal calcified masses within the muscle. Treatment may involve physical therapy, pain management, and in some cases, surgical intervention to remove the ossified tissue if it significantly impacts mobility or causes persistent pain. 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 accurate identification of the specific site of ossification.
  • Differentiation from other types of myositis or muscle disorders.
  • Need for comprehensive documentation of trauma history.
  • Potential for co-existing conditions that may complicate coding.

Audit Risk Factors

  • Inadequate documentation of the traumatic event leading to myositis.
  • Failure to specify the exact location of ossification.
  • Misclassification of myositis type.
  • 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

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 functional status.

Common Clinical Scenarios

Patients undergoing rehabilitation post-injury with myositis ossificans.

Billing Considerations

Focus on recovery goals and impact on daily activities.

Coding Guidelines

Inclusion Criteria

Use M61.052 When
  • Follow the official ICD
  • CM 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 M61.052 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 aspiration is needed due to swelling in the thigh.

Documentation Requirements

Document the reason for aspiration and findings.

Specialty Considerations

Orthopedic specialists often 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 within muscle due to trauma, leading to pain and functional impairment.