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ICD-10 Guide
ICD-10 CodesM61.06

M61.06

Billable

Myositis ossificans traumatica, lower leg

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

Code Description

ICD-10 M61.06 is a billable code used to indicate a diagnosis of myositis ossificans traumatica, lower leg.

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 in the lower leg, often as a result of direct injury, such as fractures, contusions, or surgical procedures. The pathophysiology involves the transformation of muscle cells into bone-forming cells (osteoblasts), leading to ossification in the affected area. Clinically, patients may present with localized swelling, pain, and decreased range of motion in the affected leg. Muscle weakness is common due to the disruption of normal muscle function and the presence of ectopic bone. Diagnosis is primarily clinical, supported by imaging studies such as X-rays or MRI, which can reveal the presence of calcified masses within the muscle. Treatment often involves conservative management, including physical therapy and pain control, although surgical intervention may be necessary in cases of significant impairment or persistent symptoms.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of musculoskeletal anatomy and pathology.
  • Differentiating from other forms of myositis and bone disorders.
  • Need for precise documentation of trauma history.
  • Potential for co-existing conditions affecting coding.

Audit Risk Factors

  • Inadequate documentation of trauma history.
  • Failure to specify the location of myositis ossificans.
  • 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 myositis ossificans following sports injuries or accidents.

Billing Considerations

Ensure accurate coding based on the specific site of ossification and any surgical interventions.

Physical Medicine and Rehabilitation

Documentation Requirements

Functional assessments, therapy progress notes, and patient response to treatment.

Common Clinical Scenarios

Rehabilitation following trauma leading to myositis ossificans.

Billing Considerations

Focus on documenting muscle weakness and functional limitations to support therapy coding.

Coding Guidelines

Inclusion Criteria

Use M61.06 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the trauma event and the specific location of myositis ossificans
  • Include any relevant imaging studies and treatment plans

Exclusion Criteria

Do NOT use M61.06 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 diagnoses and treatment tracking.

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 diagnoses and treatment tracking.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like myositis ossificans, improving the accuracy of diagnoses and treatment tracking.

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 or connective tissue due to trauma, leading to pain and muscle weakness.