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ICD-10 Guide
ICD-10 CodesM61.145

M61.145

Billable

Myositis ossificans progressiva, left finger(s)

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

Code Description

ICD-10 M61.145 is a billable code used to indicate a diagnosis of myositis ossificans progressiva, left finger(s).

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 is caused by mutations in the ACVR1 gene, leading to dysregulation of bone morphogenetic proteins (BMPs) that promote ossification. In the case of M61.145, the ossification occurs specifically in the left finger(s), resulting in progressive muscle stiffness, pain, and decreased mobility. Patients may experience episodes of soft tissue swelling and inflammation, which can precede the formation of heterotopic bone. The condition often leads to significant functional impairment, as the ossified areas restrict normal muscle movement and joint function. Diagnosis is typically made through clinical evaluation, imaging studies such as X-rays or MRI, and genetic testing. Management focuses on symptomatic relief and physical therapy, 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 makes documentation less common.
  • Requires specific genetic testing results for accurate coding.
  • Differentiation from other myositis conditions can be challenging.
  • Documentation must specify laterality (left finger(s)).

Audit Risk Factors

  • Insufficient documentation of genetic testing.
  • Lack of clarity on laterality (left vs. right).
  • Inadequate description of symptoms and functional limitations.
  • Failure to document the progression of the condition.

Specialty Focus

Medical Specialties

Rheumatology

Documentation Requirements

Detailed clinical notes on symptom progression, imaging results, and genetic testing.

Common Clinical Scenarios

Patients presenting with unexplained muscle stiffness and swelling.

Billing Considerations

Ensure clear documentation of the condition's impact on mobility and daily activities.

Genetics

Documentation Requirements

Genetic test results confirming ACVR1 mutations and family history.

Common Clinical Scenarios

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

Billing Considerations

Document the inheritance pattern and any related genetic counseling provided.

Coding Guidelines

Inclusion Criteria

Use M61.145 When
  • According to ICD
  • 10 guidelines, M61
  • 145 should be used when there is clear documentation of myositis ossificans progressiva affecting the left finger(s)
  • Ensure that the diagnosis is supported by clinical findings and imaging studies
  • existing

Exclusion Criteria

Do NOT use M61.145 When
  • Exclude other myositis conditions unless co

Related ICD-10 Codes

Related CPT Codes

99214CPT Code

Established patient office visit, level 4

Clinical Scenario

Used for follow-up visits to manage symptoms of myositis ossificans.

Documentation Requirements

Document history of present illness, review of systems, and physical exam findings.

Specialty Considerations

Rheumatology specialists should focus on functional assessments.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

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

ICD-9 vs ICD-10

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

Reimbursement & Billing Impact

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

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 stiffness and functional impairment.