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ICD-10 Guide
ICD-10 CodesM61.129

M61.129

Billable

Myositis ossificans progressiva, unspecified arm

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

Code Description

ICD-10 M61.129 is a billable code used to indicate a diagnosis of myositis ossificans progressiva, unspecified arm.

Key Diagnostic Point:

Myositis ossificans progressiva (MOP) is a rare genetic disorder characterized by the abnormal formation of bone in muscles and connective tissues. This condition typically begins in early childhood and progresses over time, leading to significant muscle weakness and restricted mobility. In the case of unspecified arm involvement, the ossification occurs in the muscles of the arm, which can severely limit the range of motion and functional capabilities of the affected limb. Patients may experience episodes of swelling, pain, and stiffness in the affected muscles, which can be mistaken for other inflammatory or muscular disorders. The condition is caused by mutations in the ACVR1 gene, which plays a crucial role in bone development and regulation. Diagnosis is often made through clinical evaluation, imaging studies such as X-rays or MRI, and genetic testing. Management focuses on symptomatic relief, physical therapy, and avoiding trauma to the affected areas to prevent further ossification. Due to the progressive nature of the disease, ongoing monitoring and supportive care are essential.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Rare condition with limited awareness among healthcare providers
  • Need for precise documentation of symptoms and progression
  • Potential for misdiagnosis with other muscle disorders
  • Genetic testing and results may complicate coding

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to include genetic testing results
  • Misalignment between diagnosis and treatment provided
  • Lack of specificity in coding the affected limb

Specialty Focus

Medical Specialties

Rheumatology

Documentation Requirements

Detailed clinical notes on muscle strength, range of motion, and any imaging studies performed.

Common Clinical Scenarios

Patients presenting with muscle pain and swelling, particularly after trauma or surgery.

Billing Considerations

Ensure to document the genetic basis of the condition and any family history of similar disorders.

Genetics

Documentation Requirements

Genetic test results, family history, and detailed patient history.

Common Clinical Scenarios

Patients with a family history of myositis ossificans or unexplained muscle ossification.

Billing Considerations

Documentation should include the specific mutation identified and its implications for treatment.

Coding Guidelines

Inclusion Criteria

Use M61.129 When
  • According to ICD
  • 10 guidelines, M61
  • 129 should be used when myositis ossificans progressiva is confirmed, and the specific arm affected is not documented
  • Coders should ensure that the diagnosis is supported by clinical findings and any relevant imaging or genetic testing

Exclusion Criteria

Do NOT use M61.129 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

97001CPT Code

Physical therapy evaluation

Clinical Scenario

Used for assessing functional limitations in patients with myositis ossificans progressiva.

Documentation Requirements

Detailed evaluation of muscle strength, range of motion, and functional limitations.

Specialty Considerations

Rheumatology and physical therapy should collaborate on treatment plans.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of myositis ossificans progressiva, improving the ability to track and manage this rare condition. It has also facilitated better data collection for research and treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of myositis ossificans progressiva, improving the ability to track and manage this rare condition. It has also facilitated better data collection for research and treatment outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of myositis ossificans progressiva, improving the ability to track and manage this rare condition. It has also facilitated better data collection for research and treatment outcomes.

Resources

Clinical References

  • •
    Myositis Association

Coding & Billing References

  • •
    Myositis Association

Frequently Asked Questions

What is myositis ossificans progressiva?

Myositis ossificans progressiva is a rare genetic disorder characterized by the abnormal formation of bone in muscles and connective tissues, leading to progressive muscle weakness and mobility issues.

How is myositis ossificans progressiva diagnosed?

Diagnosis typically involves clinical evaluation, imaging studies to assess bone formation, and genetic testing for mutations in the ACVR1 gene.

What are the treatment options for myositis ossificans progressiva?

Treatment focuses on managing symptoms, including pain relief and physical therapy to maintain mobility. There is currently no cure for the condition.