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ICD-10 Guide
ICD-10 CodesM61.122

M61.122

Billable

Myositis ossificans progressiva, left upper arm

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

Code Description

ICD-10 M61.122 is a billable code used to indicate a diagnosis of myositis ossificans progressiva, left upper arm.

Key Diagnostic Point:

Myositis ossificans progressiva (MOP) is a rare genetic disorder characterized by the abnormal formation of bone in muscles, tendons, and other connective tissues. This condition typically presents with progressive muscle stiffness and weakness, often following minor trauma or injury. In the case of M61.122, the ossification occurs specifically in the left upper arm, leading to significant functional impairment. Patients may experience pain, swelling, and a decrease in range of motion as the condition progresses. The ossification process can lead to the formation of heterotopic bone, which can severely restrict mobility and quality of life. Diagnosis is often confirmed through imaging studies such as X-rays or MRI, which reveal the presence of abnormal bone formation. Management of MOP is primarily supportive, focusing on pain relief and maintaining mobility, as surgical intervention is often complicated by the risk of further ossification. Understanding the nuances of this condition is crucial for accurate coding and appropriate patient management.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Rarity of the condition leading to limited familiarity among coders.
  • Specificity required in documentation to differentiate from other myositis conditions.
  • Potential for misdiagnosis with other musculoskeletal disorders.
  • Need for precise anatomical localization (left upper arm) in coding.

Audit Risk Factors

  • Inadequate documentation of the condition's progression.
  • Failure to specify the anatomical site accurately.
  • Misclassification with other types of myositis.
  • Lack of imaging studies to support the diagnosis.

Specialty Focus

Medical Specialties

Rheumatology

Documentation Requirements

Detailed clinical notes on symptoms, progression, and treatment response.

Common Clinical Scenarios

Patients presenting with unexplained muscle stiffness and pain after minor trauma.

Billing Considerations

Documentation should include family history and genetic testing results if applicable.

Orthopedics

Documentation Requirements

Surgical notes if intervention is performed, including pre-operative assessments.

Common Clinical Scenarios

Patients requiring surgical evaluation for restricted mobility due to ossification.

Billing Considerations

Careful documentation of the risks associated with surgery in patients with MOP.

Coding Guidelines

Inclusion Criteria

Use M61.122 When
  • According to ICD
  • 10 guidelines, M61
  • 122 should be used when there is clear documentation of myositis ossificans progressiva localized to the left upper arm
  • Coders must ensure that the diagnosis is supported by clinical findings and imaging results

Exclusion Criteria

Do NOT use M61.122 When
  • Exclusion criteria include other forms of myositis or conditions causing similar symptoms

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 patients with MOP experiencing joint swelling.

Documentation Requirements

Document the reason for the procedure and any imaging studies performed.

Specialty Considerations

Orthopedic specialists should ensure clear documentation of the patient's condition and treatment plan.

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 progressiva, improving the accuracy of patient records and facilitating better management of rare conditions.

ICD-9 vs ICD-10

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

Reimbursement & Billing Impact

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

Resources

Clinical References

  • •
    Myositis ossificans progressiva overview

Coding & Billing References

  • •
    Myositis ossificans progressiva overview

Frequently Asked Questions

What is myositis ossificans progressiva?

Myositis ossificans progressiva is a rare genetic disorder characterized by the abnormal formation of bone in soft tissues, leading to progressive stiffness and weakness.

How is M61.122 diagnosed?

Diagnosis is typically made through clinical evaluation, imaging studies such as X-rays or MRI, and consideration of the patient's history.

What are the treatment options for M61.122?

Treatment is primarily supportive, focusing on pain management and maintaining mobility, as surgical options carry risks of further ossification.