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ICD-10 Guide
ICD-10 CodesM61.059

M61.059

Billable

Myositis ossificans traumatica, unspecified thigh

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

Code Description

ICD-10 M61.059 is a billable code used to indicate a diagnosis of myositis ossificans traumatica, unspecified thigh.

Key Diagnostic Point:

Myositis ossificans traumatica is a condition characterized by the abnormal formation of bone tissue within muscle or soft 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 case of unspecified thigh involvement, the condition may manifest as pain, swelling, and reduced range of motion in the thigh muscles. Patients may experience muscle weakness due to the disruption of normal muscle function and the presence of ectopic bone formation. 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 causes significant impairment. Understanding the underlying muscle disorders and neuromuscular conditions is crucial for effective management and rehabilitation of affected patients.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of symptoms
  • Need for precise documentation of trauma history
  • Differentiation from other muscle disorders and conditions
  • Potential for co-existing conditions affecting coding

Audit Risk Factors

  • Inadequate documentation of trauma history
  • Failure to specify the site of ossification
  • Misclassification of myositis types
  • Lack of imaging studies to support diagnosis

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed trauma history, imaging results, and treatment plans.

Common Clinical Scenarios

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

Billing Considerations

Ensure clear documentation of the mechanism of injury and follow-up care.

Physical Medicine and Rehabilitation

Documentation Requirements

Functional assessments, rehabilitation goals, and progress notes.

Common Clinical Scenarios

Rehabilitation following trauma, management of muscle weakness.

Billing Considerations

Documenting the impact of myositis on functional abilities is crucial.

Coding Guidelines

Inclusion Criteria

Use M61.059 When
  • Follow official ICD
  • CM coding guidelines, ensuring accurate documentation of the condition's etiology and location
  • Include any relevant external cause codes if applicable

Exclusion Criteria

Do NOT use M61.059 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 involvement is suspected alongside myositis.

Documentation Requirements

Document the reason for aspiration and findings.

Specialty Considerations

Orthopedic specialists should ensure clear linkage between the procedure and diagnosis.

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.

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.

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.

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 soft tissue following trauma, leading to pain and muscle weakness.