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ICD-10 Guide
ICD-10 CodesM61.26

M61.26

Billable

Paralytic calcification and ossification of muscle, lower leg

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

Code Description

ICD-10 M61.26 is a billable code used to indicate a diagnosis of paralytic calcification and ossification of muscle, lower leg.

Key Diagnostic Point:

Paralytic calcification and ossification of muscle in the lower leg is a condition characterized by the abnormal deposition of calcium salts and bone-like tissue in the muscle, often resulting from prolonged immobilization or denervation of the affected muscles. This condition can arise in patients with neuromuscular disorders, such as myositis or after significant trauma, leading to muscle weakness and atrophy. The calcification process can lead to stiffness, pain, and reduced mobility, significantly impacting the patient's quality of life. Diagnosis typically involves imaging studies, such as X-rays or MRI, to visualize the calcified areas, alongside clinical evaluation of muscle strength and function. Treatment may include physical therapy, medications to manage pain and inflammation, 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.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between calcification due to paralysis versus other causes.
  • Need for comprehensive documentation of muscle weakness and neuromuscular conditions.
  • Potential overlap with other muscle disorders requiring precise coding.
  • Variability in clinical presentation and severity among patients.

Audit Risk Factors

  • Inadequate documentation of the patient's history and physical examination.
  • Failure to document the specific neuromuscular condition leading to calcification.
  • Lack of imaging studies to support the diagnosis.
  • Inconsistent coding of related conditions or co-morbidities.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Patients with immobilization due to fractures or surgeries leading to muscle calcification.

Billing Considerations

Consideration of surgical options and rehabilitation protocols.

Neurology

Documentation Requirements

Comprehensive neurological assessments and history of neuromuscular disorders.

Common Clinical Scenarios

Patients with myositis or other neuromuscular diseases presenting with muscle weakness.

Billing Considerations

Focus on the underlying neurological condition and its management.

Coding Guidelines

Inclusion Criteria

Use M61.26 When
  • According to ICD
  • 10 coding guidelines, M61
  • 26 should be used when there is clear documentation of paralytic calcification and ossification specifically in the lower leg muscles
  • It is essential to ensure that the condition is not due to other underlying diseases or injuries that may require different coding

Exclusion Criteria

Do NOT use M61.26 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

73030CPT Code

Radiologic examination, lower extremity, complete, including hip, femur, knee, tibia, fibula, and ankle.

Clinical Scenario

Used when imaging is required to assess calcification in the lower leg.

Documentation Requirements

Radiology report detailing findings of calcification.

Specialty Considerations

Orthopedic specialists may require specific imaging views.

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 M61.26, improving the accuracy of diagnoses and treatment tracking. This specificity aids in better patient management and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like M61.26, improving the accuracy of diagnoses and treatment tracking. This specificity aids in better patient management and resource allocation.

Reimbursement & Billing Impact

reimbursement.

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 lower leg?

Common causes include prolonged immobilization due to fractures or surgeries, denervation from neurological conditions, and myositis, which can lead to muscle weakness and subsequent calcification.