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ICD-10 Guide
ICD-10 CodesM61.261

M61.261

Billable

Paralytic calcification and ossification of muscle, right lower leg

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

Code Description

ICD-10 M61.261 is a billable code used to indicate a diagnosis of paralytic calcification and ossification of muscle, right lower leg.

Key Diagnostic Point:

Paralytic calcification and ossification of muscle in the right lower leg is a condition characterized by the abnormal deposition of calcium salts and bone-like tissue within the muscle fibers. This condition often arises as a result of prolonged immobilization or disuse of the affected limb, leading to muscle weakness and atrophy. The calcification process can be associated with various neuromuscular disorders, including myositis, where inflammation of the muscle tissue occurs. Patients may present with symptoms such as pain, swelling, and reduced range of motion in the affected leg. Diagnosis typically involves imaging studies, such as X-rays or MRI, which can reveal the extent of calcification and ossification. 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 diagnosis.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of muscle pathology and neuromuscular conditions.
  • Differentiation from other muscle disorders can be challenging.
  • Documentation must specify the location and nature of the calcification.
  • Potential for co-morbid conditions that may complicate coding.

Audit Risk Factors

  • Inadequate documentation of the underlying cause of calcification.
  • Failure to specify the affected muscle group.
  • Lack of imaging studies to support the diagnosis.
  • Inconsistent coding of associated conditions.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed imaging reports, surgical notes if applicable, and physical therapy evaluations.

Common Clinical Scenarios

Post-surgical patients with immobilization, athletes with muscle injuries.

Billing Considerations

Ensure clarity on whether the calcification is post-traumatic or due to disuse.

Neurology

Documentation Requirements

Neurological assessments, history of neuromuscular disorders, and treatment plans.

Common Clinical Scenarios

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

Billing Considerations

Document any neurological evaluations that support the diagnosis of muscle calcification.

Coding Guidelines

Inclusion Criteria

Use M61.261 When
  • According to ICD
  • 10 guidelines, M61
  • 261 should be used when there is clear documentation of paralytic calcification and ossification specifically in the right lower leg
  • It is essential to ensure that the diagnosis is supported by imaging and clinical findings

Exclusion Criteria

Do NOT use M61.261 When
  • Exclusion criteria include conditions that do not involve calcification or ossification

Related ICD-10 Codes

Related CPT Codes

97001CPT Code

Physical therapy evaluation

Clinical Scenario

Used for assessing muscle function and planning rehabilitation for patients with M61.261.

Documentation Requirements

Detailed evaluation of muscle strength and range of motion.

Specialty Considerations

Orthopedic and rehabilitation specialists should document findings thoroughly.

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 M61.261, improving the accuracy of data collection and reimbursement processes. This specificity helps in better tracking of muscle disorders and their treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like M61.261, improving the accuracy of data collection and reimbursement processes. This specificity helps in better tracking of muscle disorders and their treatment outcomes.

Reimbursement & Billing Impact

reimbursement processes. This specificity helps in better tracking of muscle disorders and their treatment outcomes.

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?

Common causes include prolonged immobilization, disuse of the muscle, trauma, and certain neuromuscular disorders that lead to muscle atrophy.