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ICD-10 Guide
ICD-10 CodesM61.131

M61.131

Billable

Myositis ossificans progressiva, right forearm

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

Code Description

ICD-10 M61.131 is a billable code used to indicate a diagnosis of myositis ossificans progressiva, right forearm.

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 presents with progressive muscle stiffness and weakness, often following trauma or injury to the affected area. In the case of M61.131, the right forearm is specifically affected, leading to ossification within the muscles of the forearm. Patients may experience pain, swelling, and limited range of motion due to the formation of heterotopic bone. The condition is often misdiagnosed as a muscle strain or contusion, which can delay appropriate treatment. Diagnosis is usually confirmed through imaging studies, such as X-rays or MRI, which reveal the presence of calcified masses in the muscle tissue. Management of myositis ossificans progressiva 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 effective patient management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Rarity of the condition leading to limited familiarity among coders
  • Potential for misdiagnosis with other muscle disorders
  • Need for precise documentation of affected body part
  • Variability in clinical presentation requiring thorough assessment

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to specify the affected body part
  • Misinterpretation of imaging results
  • Lack of clear treatment plans in medical records

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed clinical notes, imaging reports, and treatment plans must be documented.

Common Clinical Scenarios

Patients presenting with unexplained muscle stiffness and pain following trauma.

Billing Considerations

Orthopedic specialists should ensure that all imaging studies are clearly linked to the diagnosis.

Physical Medicine and Rehabilitation

Documentation Requirements

Functional assessments and rehabilitation plans should be documented.

Common Clinical Scenarios

Patients requiring rehabilitation post-ossification to regain mobility.

Billing Considerations

Documentation should reflect the impact of the condition on functional abilities.

Coding Guidelines

Inclusion Criteria

Use M61.131 When
  • According to ICD
  • 10 guidelines, M61
  • 131 should be used when myositis ossificans progressiva is confirmed in the right forearm
  • Coders must ensure that the diagnosis is supported by clinical documentation and imaging findings

Exclusion Criteria

Do NOT use M61.131 When
  • Exclusion criteria include other forms of myositis or ossification that do not meet the specific criteria for MOP

Related ICD-10 Codes

Related CPT Codes

97001CPT Code

Physical therapy evaluation

Clinical Scenario

Used for assessing functional limitations in patients with myositis ossificans.

Documentation Requirements

Detailed evaluation notes and treatment plans must be documented.

Specialty Considerations

Physical therapists should document the impact of the condition on mobility.

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

reimbursement.

Resources

Clinical References

  • •
    Myositis ossificans progressiva: A clinical overview

Coding & Billing References

  • •
    Myositis ossificans progressiva: A clinical overview

Frequently Asked Questions

What are the common symptoms of myositis ossificans progressiva?

Common symptoms include muscle stiffness, pain, swelling, and limited range of motion in the affected area, often following trauma.