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ICD-10 Guide
ICD-10 CodesM61.21

M61.21

Billable

Paralytic calcification and ossification of muscle, shoulder

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

Code Description

ICD-10 M61.21 is a billable code used to indicate a diagnosis of paralytic calcification and ossification of muscle, shoulder.

Key Diagnostic Point:

Paralytic calcification and ossification of muscle in the shoulder region is a condition characterized by the abnormal deposition of calcium salts in muscle tissue, leading to stiffness, pain, and reduced mobility. This condition often arises as a complication of neuromuscular disorders, prolonged immobilization, or trauma. In the shoulder, it can result from conditions such as myositis, where inflammation of the muscle tissue occurs, leading to muscle weakness and dysfunction. The calcification process can be a response to muscle injury or degeneration, where the body attempts to repair the damaged tissue but instead leads to ossification. Patients may present with symptoms such as localized pain, swelling, and limited range of motion in the shoulder joint. Diagnosis typically involves imaging studies such as X-rays or MRI to visualize the calcified areas. Treatment may include physical therapy, pain management, and in some cases, surgical intervention to remove the calcified tissue. Understanding the underlying causes and associated conditions is crucial for effective management and coding of this condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between calcification due to trauma versus underlying neuromuscular conditions.
  • Need for detailed documentation of symptoms and imaging findings.
  • Potential for co-morbid conditions that may complicate coding.
  • Variability in clinical presentation and treatment approaches.

Audit Risk Factors

  • Inadequate documentation of the clinical rationale for the diagnosis.
  • Failure to document co-existing conditions that may affect treatment.
  • Lack of imaging studies to support the diagnosis.
  • Misclassification of the condition due to similar codes.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed notes on physical examination findings, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with shoulder pain and limited range of motion following immobilization or injury.

Billing Considerations

Ensure that all relevant imaging studies are included in the documentation to support the diagnosis.

Neurology

Documentation Requirements

Comprehensive history of neuromuscular symptoms, including muscle weakness and previous diagnoses.

Common Clinical Scenarios

Patients with underlying neuromuscular disorders presenting with new shoulder symptoms.

Billing Considerations

Document any neurological assessments performed to differentiate from other conditions.

Coding Guidelines

Inclusion Criteria

Use M61.21 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the condition's etiology and any associated symptoms
  • Include details on the duration of symptoms and any prior treatments

Exclusion Criteria

Do NOT use M61.21 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

73030CPT Code

X-ray shoulder, 2 views

Clinical Scenario

Used to confirm calcification in the shoulder muscle.

Documentation Requirements

Include imaging results and clinical findings.

Specialty Considerations

Orthopedic specialists should ensure imaging is relevant to the diagnosis.

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 M61.21, improving the accuracy of diagnoses and treatment plans. This specificity helps in better tracking of treatment outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like M61.21, improving the accuracy of diagnoses and treatment plans. This specificity helps in better tracking of treatment outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like M61.21, improving the accuracy of diagnoses and treatment plans. This specificity helps in better tracking of treatment outcomes and resource allocation.

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 are the common causes of paralytic calcification in the shoulder?

Common causes include trauma, prolonged immobilization, and underlying neuromuscular disorders such as myositis.

How is M61.21 diagnosed?

Diagnosis typically involves a combination of clinical evaluation, imaging studies such as X-rays or MRI, and assessment of the patient's history.